| NPI | 1639516784 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTONIO JUAN ORTEGA Psychologist 347-689-9914 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NY 018373) |
| Enumeration Date | 2013-05-30 |
| Last Update Date | 2013-05-30 |