| NPI | 1174954606 |
|---|---|
| Other Name | ST. PETER'S BREAST SURGERY |
| Entity Type | Organization |
| Authorized Contact | COURTNEY KNOWLES Credentialing Manager 518-525-5634 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 208600000X Surgery |
| Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty |
| 363A00000X Physician Assistant | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2013-12-10 |
| Last Update Date | 2021-10-07 |