| NPI | 1073496402 |
|---|---|
| Doing Business As | NY KETAMINE MEDICAL PRACTICE |
| Entity Type | Organization |
| Authorized Contact | MARINA MAHONEY Head Of Rcm 913-213-1084 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2025-07-31 |
| Last Update Date | 2025-07-31 |