| NPI | 1629867890 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAILESH PATHARE Owner 718-701-6010 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine |
| Additional Taxonomies | 2083A0300X Preventive Medicine, Addiction Medicine |
| 208100000X Physical Medicine & Rehabilitation | |
| Enumeration Date | 2025-05-05 |
| Last Update Date | 2025-05-05 |