| NPI | 1184042079 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAISON CHAKKAPPAN President 914-602-6209 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 103T00000X Psychologist |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| Enumeration Date | 2014-03-29 |
| Last Update Date | 2021-08-17 |