| NPI | 1265971238 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YVONNE PASQUALICCHIO Administrative Director 845-800-9305 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2017-02-23 |
| Last Update Date | 2017-02-23 |