| NPI | 1346257979 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELYSIA M Reception/Credentialing 845-356-2900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: NY 213531) |
| Additional Taxonomies | 174400000X Specialist (Licence: NY 179160) |
| 174400000X Specialist (Licence: NY 086369) | |
| 174400000X Specialist (Licence: NY 160306) | |
| 174400000X Specialist (Licence: NY 187591) | |
| 174400000X Specialist (Licence: NY 202294) | |
| 174400000X Specialist (Licence: NY 235899) | |
| Enumeration Date | 2006-08-03 |
| Last Update Date | 2008-04-20 |