| NPI | 1912104571 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MOHEB S BOTROTH Physical Therapist 917-863-1556 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 026095) |
| Additional Taxonomies | 251C00000X (Licence: NY 026095) |
| Enumeration Date | 2007-06-28 |
| Last Update Date | 2008-07-30 |