| NPI | 1164166328 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IRA KORNBLUTH President 855-527-7246 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation |
| 2081P2900X Physical Medicine & Rehabilitation Pain Medicine | |
| 208VP0000X Pain Medicine Pain Medicine | |
| 208VP0014X Pain Medicine Interventional Pain Medicine | |
| Enumeration Date | 2022-04-25 |
| Last Update Date | 2022-04-25 |