| NPI | 1457050429 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRYAN T MAHONEY Chief Financial Officer 518-828-8090 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 261QM2500X Clinic/Center, Medical Specialty |
| Enumeration Date | 2023-02-28 |
| Last Update Date | 2023-03-22 |