| NPI | 1376433482 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DARLENE KIRLEY Billing Manager 315-367-0264 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease |
| Enumeration Date | 2025-07-09 |
| Last Update Date | 2025-08-12 |