| NPI | 1124211586 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TZE-JUNG SU President 917-892-4834 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy |
| Enumeration Date | 2007-08-20 |
| Last Update Date | 2022-06-03 |