| NPI | 1376287243 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANTE BRADY Fnp 845-407-7942 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 364SF0001X Clinical Nurse Specialist, Family Health |
| Enumeration Date | 2022-04-26 |
| Last Update Date | 2022-04-28 |