| NPI | 1528415940 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANATOLY STAROSTA Owner 917-957-8100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy |
| Additional Taxonomies | 174400000X Specialist (Licence: NY 018713) |
| Enumeration Date | 2016-05-16 |
| Last Update Date | 2016-05-16 |