| NPI | 1386019834 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE PULEO O'BRIEN Director 315-853-6090 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty (Licence: NY 014074) |
| Enumeration Date | 2015-12-09 |
| Last Update Date | 2015-12-09 |