| NPI | 1487377032 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN YUDHISTIRA Psychiatric Nurse Practitioner 347-229-3939 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2022-09-20 |
| Last Update Date | 2022-09-20 |