| NPI | 1104428796 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ILANA ETELZON Md 718-682-3686 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine |
| Additional Taxonomies | 261QM2500X Clinic/Center, Medical Specialty |
| Enumeration Date | 2020-11-10 |
| Last Update Date | 2022-05-16 |