| NPI | 1548346307 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OLEG FUZAYLOV Supervising Physician 718-275-5200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| Enumeration Date | 2006-10-27 |
| Last Update Date | 2007-09-05 |