| NPI | 1205693819 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GYULNARA AVSHALUMOVA PT 917-697-2617 |
| Organization Subpart ? | No |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation |
| Enumeration Date | 2024-02-29 |
| Last Update Date | 2024-03-15 |