| NPI | 1124638747 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BARRY DOUGLAS JUPITER President 516-374-6838 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine |
| 208100000X Physical Medicine & Rehabilitation | |
| 2085R0202X Radiology, Diagnostic Radiology | |
| 225100000X Physical Therapist | |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2020-08-07 |
| Last Update Date | 2020-08-07 |