| NPI | 1265794457 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VILMA JUNIO Physician/President 315-342-4217 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care (Licence: NY 233306) |
| 261QP2300X Clinic/Center, Primary Care (Licence: NY 525939) | |
| Enumeration Date | 2012-06-13 |
| Last Update Date | 2022-10-19 |