| NPI | 1124394457 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHADEN GHATTAS RYGLEWICZ Owner 631-271-9151 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 028157) |
| Enumeration Date | 2012-03-30 |
| Last Update Date | 2022-05-02 |