| NPI | 1164584363 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS TEYIBO Director 718-672-5529 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: NY 215979) |
| Additional Taxonomies | 261Q00000X (Licence: NY 215979) |
| Enumeration Date | 2006-12-14 |
| Last Update Date | 2007-10-11 |