| NPI | 1396714945 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY M OONK Hr Manager 315-479-5070 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical |
| 363LP2300X Nurse Practitioner, Primary Care | |
| 213ES0103X Podiatrist, Foot & Ankle Surgery | |
| Enumeration Date | 2006-03-16 |
| Last Update Date | 2010-05-13 |