| NPI | 1457728420 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACOB DOMINIK Owner 585-385-6070 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: NY 257520-1) |
| Additional Taxonomies | 207RS0012X Internal Medicine, Sleep Medicine |
| 2084N0400X Psychiatry & Neurology, Neurology | |
| 2084S0012X Psychiatry & Neurology, Sleep Medicine | |
| 261QS1200X Clinic/Center, Sleep Disorder Diagnostic (Licence: NY 257520-1) | |
| 363A00000X Physician Assistant | |
| 363AM0700X Physician Assistant, Medical | |
| 363LF0000X Nurse Practitioner, Family | |
| Enumeration Date | 2015-08-26 |
| Last Update Date | 2022-09-13 |