| NPI | 1295131175 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAM RAHAT Executive Director 347-683-3008 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation |
| Additional Taxonomies | 208VP0014X Pain Medicine, Interventional Pain Medicine |
| 207QA0401X Family Medicine, Addiction Medicine | |
| 208VP0000X Pain Medicine, Pain Medicine | |
| 111NX0800X Chiropractor, Orthopedic | |
| 111N00000X Chiropractor | |
| Enumeration Date | 2014-11-05 |
| Last Update Date | 2017-02-21 |