| NPI | 1427592195 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY ANN DIRIENZO Credentialing Specialist 716-984-2090 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: NY 195126) |
| Enumeration Date | 2016-12-14 |
| Last Update Date | 2016-12-14 |