| NPI | 1982907739 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STACEY WHITE Owner 516-385-1525 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 208000000X Pediatrics | |
| Enumeration Date | 2010-12-17 |
| Last Update Date | 2010-12-17 |