| NPI | 1831785872 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LATCHMI NAGASWAR Project Manager 347-379-4500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 104100000X Social Worker | |
| 171100000X Acupuncturist | |
| 225100000X Physical Therapist | |
| Enumeration Date | 2020-12-14 |
| Last Update Date | 2020-12-14 |