| NPI | 1689130163 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRACHA MAZIN Physician Assistant 201-645-4336 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine |
| Additional Taxonomies | 207LA0401X Anesthesiology, Addiction Medicine |
| 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine | |
| 225100000X Physical Therapist | |
| 363AM0700X Physician Assistant, Medical | |
| Enumeration Date | 2019-02-20 |
| Last Update Date | 2019-02-20 |