| NPI | 1356937916 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY Q BUMPARS Nurse Practitioner 347-620-8901 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2020-12-17 |
| Last Update Date | 2023-01-02 |