| NPI | 1053876524 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EFRAIN ACOSTA-LEON Medical Director 917-513-6588 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry |
| Enumeration Date | 2019-02-08 |
| Last Update Date | 2021-08-18 |