| NPI | 1174825343 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IGOR PRIVEN Medical Director 718-896-6443 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine |
| Enumeration Date | 2010-11-22 |
| Last Update Date | 2011-12-21 |