| NPI | 1790496172 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARGARET ELAINE MONTGOMERY Owner 718-635-3583 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2022-12-07 |
| Last Update Date | 2022-12-07 |