| NPI | 1114093358 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICIA IRENE SHANNON Office Manager 845-229-2600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NY 1662161) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 1544321) |
| Enumeration Date | 2006-11-28 |
| Last Update Date | 2025-09-11 |