| NPI | 1366917163 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARAH BLAKE President 718-541-1864 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine |
| 261QP3300X Clinic/Center, Pain | |
| Enumeration Date | 2018-10-08 |
| Last Update Date | 2019-02-26 |