| NPI | 1720802325 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICIA CATHERINE AYALA Organizer 315-521-8858 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Enumeration Date | 2024-11-11 |
| Last Update Date | 2024-11-11 |