| NPI | 1912607300 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IRA KORNBLUTH President 855-527-7246 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation |
| Additional Taxonomies | 207LP2900X Anesthesiology Pain Medicine |
| 207L00000X Anesthesiology | |
| 208VP0000X Pain Medicine Pain Medicine | |
| 208VP0014X Pain Medicine Interventional Pain Medicine | |
| 225100000X Physical Therapist | |
| 363A00000X Physician Assistant | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2023-03-06 |
| Last Update Date | 2023-05-18 |