| NPI | 1376981035 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWARD BROCCOLI President 914-844-2864 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: NY 166111) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 193448) |
| 207L00000X Anesthesiology | |
| Enumeration Date | 2013-06-04 |
| Last Update Date | 2013-06-04 |