| NPI | 1205174075 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VANESS GOURDINE Director 201-488-6678 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Enumeration Date | 2013-01-29 |
| Last Update Date | 2013-01-29 |