| NPI | 1205947678 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLENE VITALE Owner 585-424-3410 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: NY 186511-1) |
| Additional Taxonomies | 261QM2500X Clinic/Center, Medical Specialty |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2024-09-12 |