| NPI | 1336698406 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICIA H MADDEN Practice Manager 315-935-9247 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: NY 282257) |
| Additional Taxonomies | 207N00000X Dermatology |
| 207ND0101X Dermatology, MOHS-Micrographic Surgery | |
| Enumeration Date | 2016-09-29 |
| Last Update Date | 2023-03-16 |