| NPI | 1598344962 |
|---|---|
| Doing Business As | NONE |
| Entity Type | Organization |
| Authorized Contact | JEMMRY PANTIN Manager 347-647-0345 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation |
| Additional Taxonomies | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine |
| 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine | |
| 2081N0008X Physical Medicine & Rehabilitation, Neuromuscular Medicine | |
| 2081P0301X Physical Medicine & Rehabilitation, Brain Injury Medicine | |
| Enumeration Date | 2021-04-05 |
| Last Update Date | 2021-04-23 |