| NPI | 1831819531 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRUCE BACCI Administrator 201-500-9755 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Additional Taxonomies | 103T00000X Psychologist |
| 2084B0040X Psychiatry & Neurology, Behavioral Neurology & Neuropsychiatry | |
| Enumeration Date | 2022-09-01 |
| Last Update Date | 2025-01-23 |