| NPI | 1053502724 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VIKTOR GRIBENKO President 718-946-7967 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0400X Clinic/Center Rehabilitation (Licence: NY 211122) |
| Enumeration Date | 2007-08-07 |
| Last Update Date | 2007-08-07 |