| NPI | 1154631562 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STAN GORSHKOV Office Manadger 718-676-0560 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: NY 257759) |
| Enumeration Date | 2010-10-19 |
| Last Update Date | 2010-10-19 |