| NPI | 1619900354 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAVEL KULIK Medical Director 718-396-1000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation Pain Medicine (Licence: NY 224945) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 228241) |
| 207Y00000X Otolaryngology (Licence: NY 211012) | |
| 208800000X Urology (Licence: NY 236385) | |
| 213EP1101X Podiatrist Primary Podiatric Medicine (Licence: NY N006031) | |
| Enumeration Date | 2006-07-08 |
| Last Update Date | 2009-10-27 |