| NPI | 1245643501 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHY-ANN CAROL IRISH-BENJAMIN Owner 315-725-2773 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NY 172945) |
| Enumeration Date | 2014-06-04 |
| Last Update Date | 2024-10-24 |