| NPI | 1295255149 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MINI THOMAS Ccrp 201-956-9483 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry |
| Additional Taxonomies | 2084A0401X Psychiatry & Neurology, Addiction Medicine |
| Enumeration Date | 2017-06-21 |
| Last Update Date | 2019-03-18 |