| NPI | 1376642371 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH WISNOSKI Vice President Finance 631-473-1320 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2023-01-04 |