| NPI | 1710957683 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DREISLY VILLAMAN Medical Biller 914-375-8700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251V00000X Voluntary or Charitable |
| Additional Taxonomies | 261QD1600X Clinic/Center Developmental Disabilities |
| Enumeration Date | 2006-01-24 |
| Last Update Date | 2020-01-15 |