| NPI | 1518086735 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID LOUIS MARASCIULLO Clinical Director 631-643-7390 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NY 3879) |
| Enumeration Date | 2007-03-28 |
| Last Update Date | 2011-05-25 |