| NPI | 1962775882 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELLEN EDGAR Owner 718-544-4200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation |
| Enumeration Date | 2012-02-23 |
| Last Update Date | 2015-01-28 |