| NPI | 1265495451 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELLEN COOPER Administrator 518-453-2361 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: NY 0101219R) |
| Enumeration Date | 2006-04-10 |
| Last Update Date | 2015-02-24 |