| NPI | 1558178764 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CASSANDRA FORTUNE Pmhnp C 845-659-4508 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2024-12-12 |
| Last Update Date | 2025-06-21 |