| NPI | 1891148961 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TARIQUE PERERA Owner 203-561-5063 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084B0040X Psychiatry & Neurology, Behavioral Neurology & Neuropsychiatry |
| Enumeration Date | 2016-07-13 |
| Last Update Date | 2016-07-13 |