| NPI | 1821596586 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORAINE ANTOINE Member 917-363-6433 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 029251) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 016510) |
| Enumeration Date | 2018-01-29 |
| Last Update Date | 2018-01-29 |