| NPI | 1356358378 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA RIVERA Medical Board Director 718-270-7379 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| Enumeration Date | 2006-08-02 |
| Last Update Date | 2020-08-22 |