| NPI | 1063806768 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL JOSEPH TULLOCH Sole Owner 315-265-4772 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 175113) |
| Enumeration Date | 2015-03-20 |
| Last Update Date | 2015-03-20 |