| NPI | 1164047718 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FRED USOH Physician Owner 917-495-6239 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine |
| Enumeration Date | 2020-06-10 |
| Last Update Date | 2020-06-10 |