| NPI | 1366874885 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANE M STAMAS Senior Credentialing COO Rdinator 518-782-3742 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 262921) |
| Enumeration Date | 2013-08-07 |
| Last Update Date | 2013-08-07 |