| NPI | 1710011465 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN E LUGO Owner 646-361-1501 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: NY 025272) |
| Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy (Licence: NJ 40QA01210900) |
| 261QP2000X Clinic/Center, Physical Therapy (Licence: MD 22051) | |
| 261QP2000X Clinic/Center, Physical Therapy (Licence: PA PT019858) | |
| Enumeration Date | 2007-03-15 |
| Last Update Date | 2012-05-22 |