| NPI | 1700634953 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGIE RUTH HYLTON Member 516-410-6238 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Enumeration Date | 2024-05-10 |
| Last Update Date | 2024-05-10 |