| NPI | 1770908162 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OMANAMHE MASAGBOR M.D. 516-255-3773 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 262842) |
| Additional Taxonomies | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: NY 262842) |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: NY 262842) | |
| Enumeration Date | 2014-02-21 |
| Last Update Date | 2014-02-25 |