| NPI | 1821768375 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY DOMOND President 516-654-8600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TB0200X Psychologist, Cognitive & Behavioral |
| Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent |
| 251S00000X | |
| 261QD1600X Clinic/Center, Developmental Disabilities | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2021-09-16 |
| Last Update Date | 2021-09-16 |