| NPI | 1275258675 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE M ALLEN Office Manager/Payer Manager 917-983-2615 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2022-10-07 |
| Last Update Date | 2023-02-22 |