| NPI | 1639377849 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FERMIN P GONZALEZ Doctor 718-898-5200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health (Licence: NY 205495) |
| Enumeration Date | 2007-07-10 |
| Last Update Date | 2017-03-17 |