| NPI | 1578698908 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAE O PARK Md 718-986-5841 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: NY 130080-1) |
| Enumeration Date | 2007-02-23 |
| Last Update Date | 2020-08-22 |