| NPI | 1003291212 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | INGRID TANYA GUAY Practice Manager 518-409-8860 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY F339376-1) |
| Enumeration Date | 2015-07-29 |
| Last Update Date | 2015-07-29 |