| NPI | 1316548738 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COURTNEY KNOWLES Credentialing Manager 518-525-5634 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease |
| Additional Taxonomies | 207RC0001X Internal Medicine Clinical Cardiac Electrophysiology |
| 207RI0011X Internal Medicine Interventional Cardiology | |
| 207RP1001X Internal Medicine Pulmonary Disease | |
| 261QM1300X Clinic/Center Multi-Specialty | |
| 363A00000X Physician Assistant | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2020-11-03 |
| Last Update Date | 2022-09-19 |