| NPI | 1306050893 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ARIETA PAMELA SMITH Clinicnurse 718-436-7600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: NY 239996) |
| Additional Taxonomies | 261QD1600X Clinic/Center, Developmental Disabilities (Licence: NY 239996) |
| Enumeration Date | 2007-05-10 |
| Last Update Date | 2025-09-11 |