| NPI | 1194564476 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID MICHAEL O'CONNOR Owner 315-982-8673 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2024-05-24 |
| Last Update Date | 2024-05-24 |