| NPI | 1457800534 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFF CORNATZOR Secretary 516-432-1790 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NY 074680) |
| Enumeration Date | 2016-09-29 |
| Last Update Date | 2016-09-29 |