| NPI | 1619435732 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAREN ALVAREZ Credentialing Coordinator 631-359-5859 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy |
| Enumeration Date | 2019-03-07 |
| Last Update Date | 2019-03-07 |