| NPI | 1942724059 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE WEBB Owner 914-924-1494 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation Pain Medicine (Licence: FL OS14566) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: FL OS14566) |
| 261QR0400X Clinic/Center Rehabilitation | |
| Enumeration Date | 2017-07-31 |
| Last Update Date | 2018-01-24 |