| NPI | 1548791494 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GENA GUSTIN Director Of Operations 516-812-2000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: FL 1009309) |
| Additional Taxonomies | 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: FL 5001) |
| Enumeration Date | 2017-03-22 |
| Last Update Date | 2022-07-21 |