| NPI | 1528384872 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STACEY ANNE WHITE Owner 516-799-5407 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: NY 199041) |
| Enumeration Date | 2010-04-12 |
| Last Update Date | 2010-04-12 |