| NPI | 1558144782 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANE ANTIONETTE THOMPSON Owner/Physician 917-751-4262 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation |
| Enumeration Date | 2023-08-14 |
| Last Update Date | 2023-08-14 |