| NPI | 1457706731 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COURTNEY KNOWLES Credentialing Manager 518-525-5634 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 2084N0600X Psychiatry & Neurology Clinical Neurophysiology | |
| 208M00000X Hospitalist | |
| 261QM1300X Clinic/Center Multi-Specialty | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2016-04-25 |
| Last Update Date | 2021-10-07 |