| NPI | 1538421946 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANDIE MALONEY Medical Biller 631-784-7803 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TP0016X Psychologist, Prescribing (Medical) (Licence: NY 00168136) |
| Enumeration Date | 2012-06-12 |
| Last Update Date | 2012-06-12 |