| NPI | 1326329749 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OMAR AYALA President 800-943-1817 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: NJ 25MA08727400) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NJ 25MA08727400) |
| Enumeration Date | 2011-08-30 |
| Last Update Date | 2011-08-30 |