| NPI | 1568904639 |
|---|---|
| Doing Business As | SHIBANI RAY-MAZUMDER |
| Entity Type | Organization |
| Authorized Contact | SHIBANI RAY-MAZUMDER Clinical Psychologist/Director 631-786-9312 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: NY 02069-1) |
| Additional Taxonomies | 103TH0004X Psychologist, Health (Licence: NY 020691-1) |
| Enumeration Date | 2016-11-07 |
| Last Update Date | 2020-09-08 |