| NPI | 1518404417 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWARD SHALTS Owner 646-301-2578 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 209237) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY F401988) |
| Enumeration Date | 2017-01-30 |
| Last Update Date | 2017-01-30 |