| NPI | 1831733120 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA MADALONE Owner 718-687-2987 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health |
| Enumeration Date | 2019-10-30 |
| Last Update Date | 2020-07-13 |