| NPI | 1730639121 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHLEEN BRUSH Credentialing Coordinator Manager 718-819-6805 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist |
| Enumeration Date | 2016-10-10 |
| Last Update Date | 2018-03-14 |