Organization
MASTER FASTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOEL GELB (CHEIF EXECUTIVE OFFICER)
(845) 477-5000
Entity
Organization
Contact information
Practice address
105 SCHUNNEMUNK RD, SUITE 112, MONROE, NY 10950-6104
(845) 477-5000
Mailing address
105 SCHUNNEMUNK RD, SUITE 112, MONROE, NY 10950-6104
(845) 477-5000
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
P04443
NY
Other
Enumeration date
11/28/2016
Last updated
11/28/2016
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