| NPI | 1417077579 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMIE GLICK Director 631-659-3800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: NY 020999-1) |
| Enumeration Date | 2007-03-30 |
| Last Update Date | 2016-09-08 |