| NPI | 1255787743 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERTO MANCUSO Owner 212-457-0878 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: NY 278727) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NY 284074) |
| 207XS0106X Orthopaedic Surgery, Hand Surgery (Licence: NY 211177) | |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: NY 284074) | |
| 208100000X Physical Medicine & Rehabilitation (Licence: NY 278727) | |
| 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine (Licence: NY 278727) | |
| 363A00000X Physician Assistant (Licence: NY 014633) | |
| 363AM0700X Physician Assistant, Medical (Licence: NY 014633) | |
| 363AS0400X Physician Assistant, Surgical (Licence: NY 014633) | |
| Enumeration Date | 2016-05-13 |
| Last Update Date | 2024-11-13 |