| NPI | 1891516423 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHLEEN BRUSH Manager Of Credentialing 631-359-5805 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy |
| Additional Taxonomies | 261QX0100X Clinic/Center, Occupational Medicine |
| Enumeration Date | 2024-10-17 |
| Last Update Date | 2024-10-17 |