| NPI | 1083724264 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NANCY LYNNE MATTHEWS Administrator 516-599-4475 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 13282) |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2007-08-18 |