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Organization

EQUIP HEALTH MEDICAL NY PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
CAITLYN DEFIORE (DIRECTOR CLIENT OPERATIONS)
(508) 340-1419
Entity
Organization

Contact information

Practice address
244 MADISON AVE # 1176, NEW YORK, NY 10016-2817
(619) 350-6290
(619) 436-4739
Mailing address
PO BOX 131747, CARLSBAD, CA 92013-1747
(619) 350-6290

Taxonomy

Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
133V00000X
Registered Dietitian
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary

Other

Enumeration date
01/16/2021
Last updated
01/16/2021
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