| 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 |