| NPI | 1811280795 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLO WISOTSKY Psychologist/President 631-804-8830 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TH0004X Psychologist Health (Licence: NY 016173) |
| Additional Taxonomies | 103TB0200X Psychologist Cognitive & Behavioral (Licence: NY 016173) |
| Enumeration Date | 2011-05-25 |
| Last Update Date | 2011-05-25 |