| NPI | 1649524851 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWARD J. PAKSTIS Md 516-678-6816 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: NY 160126-1) |
| Enumeration Date | 2012-11-09 |
| Last Update Date | 2017-04-12 |