| NPI | 1396020145 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEREMIE RACHUNOW Officer 212-510-7020 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 220017-1) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: NY x010496-1) |
| Enumeration Date | 2011-10-12 |
| Last Update Date | 2011-10-12 |