| NPI | 1255617254 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT MORGANO Team Leader 845-291-0100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: NY 072134-1) |
| Enumeration Date | 2011-10-24 |
| Last Update Date | 2011-10-24 |