| NPI | 1639766975 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN LEWIS Administrator 914-523-3252 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry |
| Enumeration Date | 2020-12-21 |
| Last Update Date | 2020-12-21 |