| NPI | 1164793089 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM B. HEAD Doctor 718-448-5554 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: NY 109042) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: NJ 25MA02586900) |
| 2084P0800X Psychiatry & Neurology Psychiatry (Licence: NJ 25MA02586900) | |
| 2084P0800X Psychiatry & Neurology Psychiatry (Licence: NY 109042) | |
| Enumeration Date | 2012-01-24 |
| Last Update Date | 2012-01-24 |