| NPI | 1992846497 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNY T BAGEN President 716-706-5921 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: NY F400997-1) |
| Enumeration Date | 2007-02-09 |
| Last Update Date | 2008-05-05 |