| NPI | 1528191830 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GAUTAM KAUSHIK KHAKHAR Medical Director 718-549-7260 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine (Licence: NY 218201) |
| Enumeration Date | 2007-03-14 |
| Last Update Date | 2020-08-22 |