| NPI | 1457815011 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACY DESSAINT Credentialing/Billing 518-793-9820 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease |
| Additional Taxonomies | 207R00000X Internal Medicine |
| Enumeration Date | 2019-01-29 |
| Last Update Date | 2019-01-29 |