| NPI | 1063602662 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BARBARA PROVENZANO Office Manager 302-644-2773 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: DE C10006472) |
| Enumeration Date | 2007-07-30 |
| Last Update Date | 2007-07-30 |