| NPI | 1336184902 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUNITA RAYUDU President 518-496-0730 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2006-06-18 |
| Last Update Date | 2019-09-24 |