| NPI | 1962761049 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAWN A GONSALVES President/Sole Member 646-541-2449 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 243827) |
| Enumeration Date | 2012-05-10 |
| Last Update Date | 2012-05-10 |