| NPI | 1245609932 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | INDIRA SHAH Md 917-678-6319 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: NJ 25MA08626200) |
| Enumeration Date | 2015-09-23 |
| Last Update Date | 2015-11-05 |