| NPI | 1902055825 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOROTHY STACK Physical Therpist 516-796-8490 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 004337-1) |
| Enumeration Date | 2008-09-16 |
| Last Update Date | 2008-09-16 |