| NPI | 1174908743 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE L MCCOUBREY Clinical Social Worker 845-471-6004 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: NY 084217) |
| Enumeration Date | 2015-07-24 |
| Last Update Date | 2015-07-24 |