| NPI | 1164525259 |
|---|---|
| Doing Business As | DAVID J. WEGMAN |
| Entity Type | Organization |
| Authorized Contact | ANDREW WEGMAN Administrator 585-392-7171 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization |
| Enumeration Date | 2006-09-06 |
| Last Update Date | 2022-07-21 |