| NPI | 1124553557 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | INTISAR IBRAHIM Owner 201-233-2999 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family |
| Enumeration Date | 2017-04-24 |
| Last Update Date | 2023-10-11 |