| NPI | 1659667970 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OLEG BORISOV Member 718-368-0100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: NJ 25ma07870200) |
| Enumeration Date | 2011-06-24 |
| Last Update Date | 2011-12-19 |