| NPI | 1982486270 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACQUELYN FABER Owner 631-813-9940 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 225X00000X Occupational Therapist |
| Enumeration Date | 2023-10-20 |
| Last Update Date | 2023-10-20 |