| NPI | 1235359233 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL WHALEN Director Of Administration 518-435-2704 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine |
| Additional Taxonomies | 2085N0700X (Licence: NY 54964) |
| 2085N0904X (Licence: NY 54964) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 54964) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: NY 54964) | |
| 363AM0700X Physician Assistant, Medical (Licence: NY 54964) | |
| 363L00000X Nurse Practitioner (Licence: NY 54964) | |
| Enumeration Date | 2007-05-01 |
| Last Update Date | 2012-03-28 |