| NPI | 1477809325 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRYAN T MAHONEY CFO 518-828-8090 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty (Licence: NY 1001000H) |
| Enumeration Date | 2012-07-30 |
| Last Update Date | 2017-10-17 |