| NPI | 1366612723 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATHEW J ULAHANNAN Physician 315-735-6141 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 170995 1) |
| Enumeration Date | 2008-03-01 |
| Last Update Date | 2008-03-01 |