| NPI | 1134256761 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMIRA OVSHAEV Physician 718-266-9779 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 219865) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: NY 208817) |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: NY 219865) | |
| Enumeration Date | 2007-02-28 |
| Last Update Date | 2023-03-07 |