| NPI | 1003049743 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACQELINE B PEVNY President 917-699-4391 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0805X Psychiatry & Neurology, Geriatric Psychiatry (Licence: FL ME81382) |
| Enumeration Date | 2009-08-28 |
| Last Update Date | 2024-08-19 |