| NPI | 1578937579 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD CARL KOFFLER President 917-903-4531 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine (Licence: CT 043130) |
| Enumeration Date | 2015-11-15 |
| Last Update Date | 2015-11-15 |