| NPI | 1871369744 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT SUPER President 917-449-7582 |
| Organization Subpart ? | No |
| Primary Taxonomy | 204C00000X Neuromusculoskeletal Medicine, Sports Medicine |
| Additional Taxonomies | 111N00000X Chiropractor |
| 207XS0117X Orthopaedic Surgery Orthopaedic Surgery of the Spine | |
| 207XX0005X Orthopaedic Surgery Sports Medicine | |
| 2081S0010X Physical Medicine & Rehabilitation Sports Medicine | |
| 208VP0014X Pain Medicine Interventional Pain Medicine | |
| Enumeration Date | 2023-11-30 |
| Last Update Date | 2023-11-30 |