| NPI | 1194448498 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ZACARIA OLIVERO CEO 716-400-9169 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207QA0401X Family Medicine, Addiction Medicine |
| 207R00000X Internal Medicine | |
| 208000000X Pediatrics | |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| Enumeration Date | 2022-09-21 |
| Last Update Date | 2022-09-21 |