| NPI | 1033567631 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHLEEN BRUSH Credentialing Coordinator Manager 718-819-6805 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 225X00000X Occupational Therapist |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| Enumeration Date | 2016-05-25 |
| Last Update Date | 2018-03-28 |