| NPI | 1386999720 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BONNIE O'CONNELL Physical Therapist 631-549-1280 |
| Organization Subpart ? | No |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency |
| Enumeration Date | 2012-07-23 |
| Last Update Date | 2012-07-23 |