| NPI | 1790373504 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACLYN A FARINO Nurse Practitioner/Owner 631-304-2711 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2021-01-07 |
| Last Update Date | 2024-01-12 |