| NPI | 1205045853 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID RANDALL DYNOF Medical Director 917-207-8490 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: NY 225074-1) |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2020-08-22 |