| NPI | 1376757161 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAEANN SELIG Admin 631-549-1280 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 252Y00000X Early Intervention Provider Agency |
| 251B00000X Case Management | |
| Enumeration Date | 2007-05-10 |
| Last Update Date | 2012-09-27 |