| NPI | 1174834642 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MYUNG AE LEE Manager 718-333-5603 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy |
| Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy (Licence: NY 029100) |
| Enumeration Date | 2010-06-29 |
| Last Update Date | 2018-08-14 |