| NPI | 1154866234 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VLADIMIR BATRIN Practice Administrator 857-452-6356 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care (Licence: MA 222926) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| 207Q00000X Family Medicine | |
| 363LP0808X Nurse Practitioner Psychiatric/Mental Health | |
| Enumeration Date | 2016-12-28 |
| Last Update Date | 2025-06-12 |