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 |