| NPI | 1992113369 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER DIBENEDETTO Licensed Clinical Social Worker 914-419-9962 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: NY R038276-1) |
| Enumeration Date | 2014-07-29 |
| Last Update Date | 2014-07-29 |