| NPI | 1154094597 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YVONNE PASQUALICCHIO Administrative Director 845-800-9305 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health |
| Enumeration Date | 2021-07-30 |
| Last Update Date | 2021-08-09 |