| NPI | 1295515773 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RANDALL LEE Member 917-608-6388 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics |
| Enumeration Date | 2023-10-03 |
| Last Update Date | 2023-10-03 |