NPI | 1447016738 |
---|---|
Entity Type | Organization |
Authorized Contact | SHANEQUA A BOONE Nurse Practitioner 631-629-2269 |
Organization Subpart ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
Enumeration Date | 2024-02-23 |
Last Update Date | 2024-02-23 |