| NPI | 1518117175 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL JOHN SERRA TORRES Owner 718-710-6342 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207XX0801X Orthopaedic Surgery Orthopaedic Trauma (Licence: PR 17144) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PR 17144) |
| Enumeration Date | 2008-09-19 |
| Last Update Date | 2009-04-16 |