| NPI | 1669769949 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BORIS KHOTYLEV President 718-427-0362 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: NY 027268-1) |
| Enumeration Date | 2011-07-07 |
| Last Update Date | 2011-07-07 |