| NPI | 1164998423 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURA PASCO Executive VP, CFO 518-761-0300 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) | |
| Enumeration Date | 2018-10-15 |
| Last Update Date | 2024-02-23 |