| NPI | 1083708283 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MOHAMMAD REZA GHAZI-MOGHADAM Physician 518-843-1449 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: NY 1326381) |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2020-08-22 |