| NPI | 1972315927 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RYAN MICHAEL BADOLATO Member, Owner 646-535-8776 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Additional Taxonomies | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry |
| Enumeration Date | 2025-01-24 |
| Last Update Date | 2025-01-24 |