| NPI | 1437517463 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENISE OCTAVIANI President Owner 315-703-3263 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 197696) |
| Enumeration Date | 2016-02-04 |
| Last Update Date | 2016-02-04 |