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 | 213E00000X Podiatrist |
133N00000X Nutritionist | |
133V00000X Dietitian, Registered | |
133NN1002X Nutritionist, Nutrition, Education | |
103T00000X Psychologist | |
103TB0200X Psychologist, Cognitive & Behavioral | |
Enumeration Date | 2009-05-28 |
Last Update Date | 2015-07-01 |