| NPI | 1104468099 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NOSA DENNIS AIGBE LEBARTY Owner 518-951-0740 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine |
| Enumeration Date | 2019-10-11 |
| Last Update Date | 2020-04-09 |