| NPI | 1972070530 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN MARTINEZ Partner 347-988-8598 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Enumeration Date | 2018-10-31 |
| Last Update Date | 2018-10-31 |