| NPI | 1558800482 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUBY MANGSATABAM Manager 920-345-6769 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NJ 25MA09485900) |
| Enumeration Date | 2017-02-12 |
| Last Update Date | 2017-02-12 |