| NPI | 1306096995 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEAN M COPPOLA Billing Manager 718-651-7770 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: NY 6734124) |
| Enumeration Date | 2008-09-19 |
| Last Update Date | 2008-09-19 |