| NPI | 1396022752 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUSSALETTE MAGBANUA Clinical Director 917-459-3695 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0400X Clinic/Center, Rehabilitation (Licence: NY 010144) |
| Additional Taxonomies | 261QH0700X Clinic/Center, Hearing and Speech (Licence: NY 012509) |
| 261QP2000X Clinic/Center, Physical Therapy (Licence: NY 022020) | |
| Enumeration Date | 2011-11-12 |
| Last Update Date | 2011-11-12 |