| NPI | 1114630027 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA KENNEDY COO 212-620-3053 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Additional Taxonomies | 103TP2701X Psychologist, Group Psychotherapy |
| 208VP0014X Pain Medicine, Interventional Pain Medicine | |
| Enumeration Date | 2023-01-05 |
| Last Update Date | 2025-07-02 |