| NPI | 1699244368 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LATOYA GAUNTLETT-FREEMAN Owner 631-867-6757 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2018-11-24 |
| Last Update Date | 2026-02-19 |