| NPI | 1669182754 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATASHA WALLACE Medical Doctor 718-270-1000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry |
| Enumeration Date | 2022-11-29 |
| Last Update Date | 2023-02-08 |