| NPI | 1669873733 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER RUCCI Owner 888-849-7379 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| 207R00000X Internal Medicine | |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2014-09-09 |
| Last Update Date | 2022-04-21 |