| NPI | 1235338625 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RENATO YAP MANDANAS Owner/Employer 315-342-1765 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 152086) |
| Enumeration Date | 2007-07-16 |
| Last Update Date | 2023-08-18 |