| NPI | 1881650869 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WINIFRED B. MACK Executive Director 631-968-9000 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| 2084P0805X Psychiatry & Neurology, Geriatric Psychiatry | |
| Enumeration Date | 2006-04-26 |
| Last Update Date | 2008-08-13 |