| NPI | 1215501465 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW CROWLEY Pa 518-886-8066 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2021-05-13 |
| Last Update Date | 2023-08-05 |