| NPI | 1497170971 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KONSTANTIN LUKIN President 917-903-1901 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NY 35SI00522900) |
| Enumeration Date | 2014-02-20 |
| Last Update Date | 2025-02-12 |