| NPI | 1770102493 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE MURRAY Director 631-688-1047 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist |
| Additional Taxonomies | 103T00000X Psychologist |
| 103TB0200X Psychologist, Cognitive & Behavioral | |
| 103TF0000X Psychologist, Family | |
| 103TH0004X Psychologist, Health | |
| 103TH0100X Psychologist, Health Service | |
| 103TR0400X Psychologist, Rehabilitation | |
| Enumeration Date | 2020-04-13 |
| Last Update Date | 2020-04-13 |