| NPI | 1649403320 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL LANCE GERSTENFELD Owner/Manager 203-297-6120 |
| Organization Subpart ? | No |
| Primary Taxonomy | 204C00000X Neuromusculoskeletal Medicine, Sports Medicine (Licence: CT 031959) |
| Enumeration Date | 2009-08-28 |
| Last Update Date | 2010-09-16 |