| NPI | 1568657575 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MALAK ISHAK AZAB Doctor Of Physical Therapy 631-467-3381 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: NY 021295) |
| Enumeration Date | 2007-09-12 |
| Last Update Date | 2023-06-19 |