| NPI | 1467823443 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBRA COANE Office Manager 631-681-4754 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084A0401X Psychiatry & Neurology Addiction Medicine (Licence: NY 197603) |
| Enumeration Date | 2015-10-15 |
| Last Update Date | 2015-10-15 |