| NPI | 1710318175 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARCO LOPEZ Manager 347-378-8869 |
| Organization Subpart ? | No |
| Primary Taxonomy | 204R00000X Electrodiagnostic Medicine (Licence: NJ 25ma07863200) |
| Enumeration Date | 2013-12-10 |
| Last Update Date | 2025-01-29 |