| NPI | 1245596980 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACEY D SMITH Staff Accountant 607-431-5305 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 010983) |
| Enumeration Date | 2012-04-06 |
| Last Update Date | 2012-04-06 |