| NPI | 1457968299 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW WERT Owner 718-489-1130 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation |
| Additional Taxonomies | 207QS0010X Family Medicine, Sports Medicine |
| 213ES0103X Podiatrist, Foot & Ankle Surgery | |
| Enumeration Date | 2020-09-25 |
| Last Update Date | 2023-10-23 |