| NPI | 1528351988 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW DAVID ANGELILLO Director 111-111-1111 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 024794) |
| Enumeration Date | 2011-05-18 |
| Last Update Date | 2011-05-18 |