| NPI | 1295003689 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NIVEA BRIGGITTE CALICO Owner 347-218-2908 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 258021) |
| Enumeration Date | 2011-12-13 |
| Last Update Date | 2011-12-13 |