| NPI | 1124863162 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEAN FATIMA RYALS Owner 516-350-8564 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Enumeration Date | 2024-07-01 |
| Last Update Date | 2024-07-01 |