| NPI | 1407995046 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TEODORO Y PANG Owner 516-931-1978 |
| Organization Subpart ? | No |
| Primary Taxonomy | 204C00000X Neuromusculoskeletal Medicine, Sports Medicine (Licence: NY 126797) |
| Enumeration Date | 2007-02-06 |
| Last Update Date | 2020-08-22 |