NPI | 1942741632 |
---|---|
Entity Type | Organization |
Authorized Contact | GERARD JAMES FUSARO Provider 516-557-7596 |
Organization Subpart ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: NY X033339) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 022715) |
Enumeration Date | 2017-03-14 |
Last Update Date | 2017-03-22 |