| NPI | 1154157626 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT I GOLDMAN Owner 631-499-7500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 103TC0700X Psychologist Clinical |
| 103TC1900X Psychologist Counseling | |
| 103TF0200X Psychologist Forensic | |
| Enumeration Date | 2024-09-11 |
| Last Update Date | 2024-09-11 |