| NPI | 1235904533 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RENEE KROCHEK Member 516-405-0020 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 225X00000X Occupational Therapist |
| 235Z00000X Speech-Language Pathologist, | |
| Enumeration Date | 2023-11-17 |
| Last Update Date | 2023-11-17 |