| NPI | 1942695275 |
|---|---|
| Doing Business As | PROSPECT MEDICAL |
| Entity Type | Organization |
| Authorized Contact | YURA STOLYARSKY Medical Director 718-704-9909 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: NY 275763) |
| Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy (Licence: NY 275763) |
| 261QR0400X Clinic/Center, Rehabilitation (Licence: NY 275763) | |
| Enumeration Date | 2015-04-03 |
| Last Update Date | 2020-02-11 |