| NPI | 1902430200 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REBECCA A FONTANETTA Clinical Neuropsychologist 631-766-7969 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD1600X Clinic/Center, Developmental Disabilities |
| Enumeration Date | 2020-02-25 |
| Last Update Date | 2020-02-25 |