| NPI | 1124365762 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MA GIRLIE OLMEDO ACERO Physical Therapist 516-721-7504 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: NY 014002) |
| Enumeration Date | 2013-01-15 |
| Last Update Date | 2013-01-15 |