| NPI | 1912596776 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY WAYNE CIOLINO Owner 631-278-0665 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2021-01-14 |
| Last Update Date | 2021-01-14 |