| NPI | 1225243140 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH TUFFY Ubo Manager 845-938-8239 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM1100X Clinic/Center Military/U.S. Coast Guard Outpatient |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2012-12-20 |