| NPI | 1164823340 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORRAINE SULLIVAN Nurse Practitioner 516-810-0475 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY f400014) |
| Enumeration Date | 2014-09-08 |
| Last Update Date | 2014-09-08 |