| NPI | 1356621445 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BORIS MAZUROV Medical Director 718-331-9600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 213E00000X Podiatrist |
| 225100000X Physical Therapist | |
| 225X00000X Occupational Therapist | |
| Enumeration Date | 2011-08-22 |
| Last Update Date | 2011-09-16 |