| NPI | 1285869677 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREA PEREZ President 631-682-5163 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 231817) |
| Additional Taxonomies | 103T00000X Psychologist |
| 103TB0200X Psychologist Cognitive & Behavioral | |
| 133N00000X Nutritionist | |
| 133NN1002X Nutritionist Nutrition, Education | |
| 133V00000X Dietitian, Registered | |
| 213E00000X Podiatrist | |
| Enumeration Date | 2009-05-28 |
| Last Update Date | 2015-07-01 |