| NPI | 1649337890 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAQUEL G KELLY Office Manager 718-961-8817 |
| Organization Subpart ? | No |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: NY 001367) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 130031) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: NY 167790) | |
| 225100000X Physical Therapist (Licence: NY 022580) | |
| 246ZE0500X Specialist/Technologist, Other, EEG (Licence: NY 167790) | |
| 246ZE0600X Specialist/Technologist, Other, Electroneurodiagnostic (Licence: NY 167790) | |
| 2471C3402X Radiologic Technologist, Radiography (Licence: NY 107344-1) | |
| Enumeration Date | 2007-01-03 |
| Last Update Date | 2020-08-22 |