| NPI | 1194252742 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CONSTANCE LEE WOYTHAL Owner 516-987-4200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2017-05-15 |
| Last Update Date | 2020-06-08 |