| NPI | 1184814899 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ES-HAGH WISEMAN Doctor 718-268-7246 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: NY 137450) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 0158541) |
| Enumeration Date | 2007-07-29 |
| Last Update Date | 2012-08-27 |