| NPI | 1417127820 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS J. BONACUSO President 212-486-8616 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111NS0005X Chiropractor, Sports Physician (Licence: NY X005160) |
| Enumeration Date | 2008-03-03 |
| Last Update Date | 2013-08-16 |