| NPI | 1720165822 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DORIS WEINER Credentialing Specialist 212-366-8007 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NY R048688) |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2020-08-22 |