| NPI | 1053719484 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER ANTHONY BAUTISTA Practice Administrator 914-309-9564 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NJ 40QA01291900) |
| Enumeration Date | 2014-12-17 |
| Last Update Date | 2014-12-17 |