| NPI | 1306973805 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COLLEEN KNAUPP Physician Assistant 518-471-3221 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical (Licence: NY 003438) |
| Enumeration Date | 2007-02-28 |
| Last Update Date | 2020-08-22 |