| NPI | 1023447646 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEREMIAH M BENOIT Owner 518-842-7161 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: NY 257382) |
| Enumeration Date | 2013-11-04 |
| Last Update Date | 2013-11-04 |