| NPI | 1912415845 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS J BONACUSO President 646-799-2010 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111NS0005X Chiropractor, Sports Physician (Licence: NY X005160) |
| Additional Taxonomies | 111NS0005X Chiropractor, Sports Physician (Licence: X005160) |
| Enumeration Date | 2018-01-12 |
| Last Update Date | 2018-01-12 |