Organization
SUNRISE PAIN AND REHABILITATION MEDICINE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. WANDA WANG (MANAGER)
(347) 763-1091
Entity
Organization
Contact information
Practice address
4602 6TH AVE, BROOKLYN, NY 11220-1317
(347) 763-1091
(347) 763-1092
Mailing address
4602 6TH AVE, BROOKLYN, NY 11220-1317
(347) 763-1091
(347) 763-1092
Taxonomy
Speciality
Code
Description
License number
State
273Y00000X
Rehabilitation Hospital Unit
Primary
2030351
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01793177
—
NY
Enumeration date
10/04/2013
Last updated
06/09/2014
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