| NPI | 1851643456 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK THOMAS Owner 718-316-0641 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine (Licence: NY 165324) |
| Enumeration Date | 2012-10-05 |
| Last Update Date | 2012-10-05 |