| NPI | 1134179625 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYDIA SHAJENKO Director Owner 646-245-6180 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0600X (Licence: NJ 25MA08061700) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NJ 25MA08061700) |
| Enumeration Date | 2006-05-12 |
| Last Update Date | 2008-07-23 |