| NPI | 1447212063 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MITCHELL V BRODEY President 315-492-5784 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 207V00000X Obstetrics & Gynecology | |
| 363A00000X Physician Assistant | |
| 363L00000X Nurse Practitioner | |
| 291U00000X Clinical Medical Laboratory | |
| Enumeration Date | 2006-04-06 |
| Last Update Date | 2013-03-11 |