| NPI | 1144465584 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID ZIRKIEV Manager 917-406-7717 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2083S0010X Preventive Medicine, Sports Medicine |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: NY 09052) |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: NY 09052) | |
| 363AM0700X Physician Assistant, Medical (Licence: NY 006582) | |
| Enumeration Date | 2008-12-15 |
| Last Update Date | 2008-12-15 |