| NPI | 1457895278 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MOHAMMAD DJAFARI Owner 607-753-3051 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NY 211106) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 007997) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: NY 382461) | |
| Enumeration Date | 2016-12-13 |
| Last Update Date | 2016-12-13 |