| NPI | 1063405850 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM M DUTCH Medical Director Of Operations 315-701-2929 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0131X (Licence: NY N005690) |
| Enumeration Date | 2005-08-26 |
| Last Update Date | 2008-01-08 |