| NPI | 1407057839 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES JOSEPH MOEHS President 315-782-9125 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: NY 104750) |
| Enumeration Date | 2007-05-31 |
| Last Update Date | 2020-08-22 |