| NPI | 1508895657 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAREN AVANESOV Owner 718-891-7100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery Orthopaedic Surgery of the Spine (Licence: NY 238138) |
| Additional Taxonomies | 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: NY 238138) |
| 207X00000X Orthopaedic Surgery (Licence: NY 238138) | |
| Enumeration Date | 2006-07-01 |
| Last Update Date | 2013-11-25 |