| NPI | 1629558739 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ARYEH PETEGORSKY Manager 732-503-6119 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106E00000X Assistant Behavior Analyst |
| Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| 261QP2000X Clinic/Center, Physical Therapy | |
| Enumeration Date | 2018-08-17 |
| Last Update Date | 2018-08-17 |