| NPI | 1770379125 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | INGRID KAREN BUSTO GONZAGA Admininstrative Officer 347-549-0957 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center Physical Therapy |
| Enumeration Date | 2025-04-15 |
| Last Update Date | 2025-05-05 |