| NPI | 1790988533 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDGAR L. MARIN Sole Owner 631-265-6717 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: NY 131675) |
| Enumeration Date | 2007-06-08 |
| Last Update Date | 2014-08-22 |