| NPI | 1376222760 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JATOOPON MALDONADO Nurse Practitioner 718-764-3164 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2023-07-13 |
| Last Update Date | 2023-07-13 |