| NPI | 1821717711 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUDY MALAYIL Owner 917-645-2591 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363LF0000X Nurse Practitioner, Family | |
| Enumeration Date | 2022-08-24 |
| Last Update Date | 2024-04-26 |