| NPI | 1730427972 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WAYNE MICHAEL GURNICK Licensed Clinical Social Worker 631-603-7902 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NY R050891) |
| Enumeration Date | 2013-01-23 |
| Last Update Date | 2013-01-23 |