| NPI | 1831238641 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS M LA RA Manager 914-693-1050 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 208VP0014X Pain Medicine, Interventional Pain Medicine |
| Enumeration Date | 2007-02-06 |
| Last Update Date | 2025-09-11 |