| NPI | 1285763912 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELLEN CELESTE GAUGHAN Owner 518-566-8603 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NY 213308) |
| Enumeration Date | 2007-03-06 |
| Last Update Date | 2011-09-26 |