| NPI | 1124272638 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL IRA LEVI Owner 315-281-4485 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NY 217243) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 217243) |
| Enumeration Date | 2008-11-11 |
| Last Update Date | 2008-11-11 |