| NPI | 1467232678 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALICE GREENE Owner 631-681-3067 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Additional Taxonomies | 207R00000X Internal Medicine |
| Enumeration Date | 2023-10-04 |
| Last Update Date | 2024-03-08 |