| NPI | 1396868402 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS M LA RA Practice Manager 212-427-8136 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2007-04-06 |
| Last Update Date | 2020-08-22 |