| NPI | 1376895797 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOMENICK JOHN MASIELLO Owner 212-688-4818 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 204D00000X Neuromusculoskeletal Medicine & OMM |
| Enumeration Date | 2012-10-09 |
| Last Update Date | 2013-03-18 |