| NPI | 1720535099 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ABRAHAM MASARA CEO 315-552-1949 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY 401836) |
| Enumeration Date | 2016-09-04 |
| Last Update Date | 2016-09-04 |