| NPI | 1205009511 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL LEONARD NISSENBAUM President 631-737-9500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: NY 010232) |
| Enumeration Date | 2008-04-08 |
| Last Update Date | 2008-07-01 |