| NPI | 1134146079 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER RUCCI Owner 855-743-2247 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine |
| Additional Taxonomies | 101Y00000X Counselor |
| 103TC0700X Psychologist, Clinical | |
| 1041C0700X Social Worker, Clinical | |
| 207R00000X Internal Medicine | |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| 363A00000X Physician Assistant | |
| 363L00000X Nurse Practitioner | |
| 363LA2200X Nurse Practitioner, Adult Health | |
| 363LF0000X Nurse Practitioner, Family | |
| Enumeration Date | 2006-07-16 |
| Last Update Date | 2024-09-30 |