| NPI | 1124273925 |
|---|---|
| Doing Business As | FOUNTAIN MEDICAL GROUP |
| Entity Type | Organization |
| Authorized Contact | TODD R SCHLIFSTEIN Member 516-488-4411 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: NY 205272) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 217381) |
| Enumeration Date | 2008-11-20 |
| Last Update Date | 2011-04-15 |