| NPI | 1154766350 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFF CORNATZOR Secretary 516-432-1790 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NY 074680-1) |
| Enumeration Date | 2013-05-02 |
| Last Update Date | 2016-06-20 |