| NPI | 1396117628 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FERNANDO MORENO Physical Therapist 917-306-0725 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: NJ 40QA015352001) |
| Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy (Licence: NY 036219) |
| Enumeration Date | 2015-10-26 |
| Last Update Date | 2015-10-26 |