| NPI | 1740639806 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSIE JIMENEZ Office Manager 347-665-8446 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty (Licence: NY 0045351) |
| Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy (Licence: NY 0271821) |
| Enumeration Date | 2016-06-09 |
| Last Update Date | 2016-06-09 |