| NPI | 1538222740 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY E VINCENT Billing Specialist 845-344-4477 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: NY 2005021) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: NY 2175981) |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: NY 1928462) | |
| Enumeration Date | 2006-12-18 |
| Last Update Date | 2011-11-01 |