| NPI | 1740565209 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EMILY KATRINA R LACEA President 718-259-6666 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: NY 030671) |
| Enumeration Date | 2011-10-17 |
| Last Update Date | 2011-12-12 |