| NPI | 1063998706 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROSHNI DURGAM Member 516-729-5808 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: TX R5541) |
| Additional Taxonomies | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: TX Q9529) |
| Enumeration Date | 2018-07-16 |
| Last Update Date | 2018-10-18 |