| NPI | 1407363492 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA MARIE DEMBOWSKI Reimbursement Specilaist 315-478-2453 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center Multi-Specialty (Licence: NY 181112131) |
| Enumeration Date | 2017-12-29 |
| Last Update Date | 2017-12-29 |