| NPI | 1770012007 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ED TICHELI Owner 917-596-1929 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0401X Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) |
| Enumeration Date | 2017-06-09 |
| Last Update Date | 2022-07-21 |