| NPI | 1255641510 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY ANNE ROTHWELL Program Director 518-280-4294 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation |
| Additional Taxonomies | 252Y00000X Early Intervention Provider Agency (Licence: NY 012145-1) |
| Enumeration Date | 2010-10-20 |
| Last Update Date | 2018-11-30 |