NPI | 1710929047 |
---|---|
Entity Type | Organization |
Authorized Contact | MANTOSH J DEWAN President 315-464-3119 |
Organization Subpart ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
Additional Taxonomies | 103TC0700X Psychologist, Clinical |
1041C0700X Social Worker, Clinical | |
Enumeration Date | 2006-06-12 |
Last Update Date | 2020-08-22 |