| NPI | 1780996397 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THEODORE P. WASIK Psychiatrist 267-251-0756 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MA 243789) |
| Enumeration Date | 2010-07-12 |
| Last Update Date | 2010-07-12 |