| NPI | 1154769669 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PERRY STEVENS Owner 631-271-9151 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NY 179574) |
| Enumeration Date | 2013-06-06 |
| Last Update Date | 2013-06-06 |