| NPI | 1336517242 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARVIN SWANSON Executive Director 631-656-8270 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation |
| Enumeration Date | 2015-09-09 |
| Last Update Date | 2015-09-09 |