| NPI | 1306869672 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY J MCDONALD Office Manager 518-643-8008 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 162323-1) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 006858-1) |
| 363LF0000X Nurse Practitioner, Family (Licence: NY F331788) | |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2007-12-03 |