| NPI | 1043606015 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBRA COANE Office Manager 631-681-4754 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: NY F401327) |
| Enumeration Date | 2015-04-07 |
| Last Update Date | 2015-05-20 |