| NPI | 1861009839 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TATYANA SHAMAEV Administrator/Owner 917-816-5671 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD1600X Clinic/Center, Developmental Disabilities |
| Enumeration Date | 2020-09-24 |
| Last Update Date | 2020-09-24 |