| NPI | 1073149589 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KHADIJA CONLEY Billing 646-246-6919 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor |
| Additional Taxonomies | 171100000X Acupuncturist |
| 208100000X Physical Medicine & Rehabilitation | |
| 225700000X Massage Therapist | |
| 363A00000X Physician Assistant | |
| 363LG0600X Nurse Practitioner, Gerontology | |
| Enumeration Date | 2020-03-16 |
| Last Update Date | 2020-09-01 |