| NPI | 1023546207 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELINDA ANNE DE LEON Physical Therapist 917-582-4396 |
| Organization Subpart ? | No |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency (Licence: NY 023141) |
| Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy (Licence: NY 023141) |
| Enumeration Date | 2017-05-31 |
| Last Update Date | 2022-07-21 |