| NPI | 1114079639 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HEATHER MCKENZIE Office Manager 585-424-6770 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: NY 197921-1) |
| Additional Taxonomies | 174400000X Specialist (Licence: NY 120151-1) |
| 174400000X Specialist (Licence: NY 230724) | |
| 363L00000X Nurse Practitioner (Licence: NY 33554) | |
| Enumeration Date | 2007-01-17 |
| Last Update Date | 2008-09-09 |