| NPI | 1346668761 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARISA NAVARRO Senior Billing Specialist 315-942-4900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: IL 336076628) |
| Enumeration Date | 2014-04-02 |
| Last Update Date | 2014-04-02 |