| NPI | 1508289224 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MOHSAN JAN Administrator 845-821-2605 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TA0400X Psychologist, Addiction (Substance Use Disorder) (Licence: NJ MA65065) |
| Enumeration Date | 2014-01-31 |
| Last Update Date | 2014-01-31 |