| NPI | 1982412607 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OLOLADE OMOKPO Administrator 347-295-6565 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2024-12-27 |
| Last Update Date | 2025-04-17 |