| NPI | 1093743197 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BORIS ABAYEV Director 718-830-0002 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: NY 240076) |
| Additional Taxonomies | 204C00000X Neuromusculoskeletal Medicine, Sports Medicine (Licence: NY 240076) |
| 208100000X Physical Medicine & Rehabilitation (Licence: NY 240076) | |
| Enumeration Date | 2006-06-28 |
| Last Update Date | 2017-01-25 |