| NPI | 1508040650 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEYAN MA Doctor 718-888-1513 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine (Licence: NY 226971) |
| Enumeration Date | 2007-12-26 |
| Last Update Date | 2008-04-20 |