| NPI | 1093789497 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANN D BECKER Administrator 518-891-3845 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 208000000X Pediatrics |
| 207Q00000X Family Medicine | |
| Enumeration Date | 2006-02-14 |
| Last Update Date | 2015-11-04 |