NPI | 1518232115 |
---|---|
Entity Type | Organization |
Authorized Contact | MICHAEL DEMISHEV Pc Owner 631-242-4500 |
Organization Subpart ? | No |
Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation |
Additional Taxonomies | 225100000X Physical Therapist |
Enumeration Date | 2012-03-14 |
Last Update Date | 2012-03-14 |