| NPI | 1740057751 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MORADEKE OKUNOYE Manager 347-635-2021 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Enumeration Date | 2023-12-08 |
| Last Update Date | 2023-12-08 |