| NPI | 1881955086 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES H BAGLEY Owner 718-229-4868 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P2900X Psychiatry & Neurology, Pain Medicine (Licence: NY 132024) |
| Enumeration Date | 2012-06-04 |
| Last Update Date | 2012-06-04 |