| NPI | 1487185401 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATRINA STEVENS Office Supervisor 201-880-0685 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NJ 26NJ00080100) |
| Enumeration Date | 2017-03-22 |
| Last Update Date | 2017-03-22 |