| NPI | 1700907581 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTHONY J. PUCEK Nurse Practitioner 845-227-6884 |
| Organization Subpart ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: NY 278008) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY F400002) |
| Enumeration Date | 2007-04-02 |
| Last Update Date | 2020-08-22 |