| NPI | 1306480801 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICIA WILLIAMS Practice Manager 518-439-0423 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213E00000X Podiatrist |
| Additional Taxonomies | 335E00000X Prosthetic/Orthotic Supplier |
| Enumeration Date | 2019-10-29 |
| Last Update Date | 2019-10-31 |