| NPI | 1912205063 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN GEORGE Owner 631-271-7206 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 215404) |
| Enumeration Date | 2011-03-13 |
| Last Update Date | 2011-03-13 |