| NPI | 1750094306 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID R DYNOF Owner 917-207-8490 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2022-12-28 |
| Last Update Date | 2022-12-28 |