| NPI | 1376090423 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SONIA LASMIN Director 347-683-3008 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 208VP0000X Pain Medicine Pain Medicine |
| 207Q00000X Family Medicine | |
| 208100000X Physical Medicine & Rehabilitation | |
| Enumeration Date | 2016-09-07 |
| Last Update Date | 2017-05-10 |