| NPI | 1972779205 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLENN L GOLDSTEIN Owner 212-980-4211 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: NY 1859444) |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2008-05-06 |
| Last Update Date | 2008-05-07 |