| NPI | 1073866372 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARTHA HARRIS Physican Billing COO Rdinator 607-547-3909 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center Multi-Specialty (Licence: NY 150423) |
| Enumeration Date | 2012-10-24 |
| Last Update Date | 2015-04-27 |