| NPI | 1497218762 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALEX MICHELSON Administrator 917-684-4404 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology |
| Enumeration Date | 2019-04-12 |
| Last Update Date | 2019-04-12 |