| NPI | 1710179635 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDGARDO MESIAS LIVICA President/Owner 718-775-6025 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 015653) |
| Enumeration Date | 2007-08-14 |
| Last Update Date | 2011-04-05 |