| NPI | 1104543198 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUTHANN P KIRSCHEN Director Credentialing Data 516-641-6214 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation |
| Enumeration Date | 2022-10-20 |
| Last Update Date | 2022-10-20 |