| NPI | 1972633832 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT RICHARD ECKARDT Executive Director 631-943-8632 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 018173-1) |
| Enumeration Date | 2007-03-07 |
| Last Update Date | 2009-05-09 |