| NPI | 1316260045 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAE JOUN PARK President 607-762-2020 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: NY 110896) |
| Enumeration Date | 2010-03-09 |
| Last Update Date | 2010-03-09 |