| NPI | 1508229659 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARLOS O DATOR President 315-343-2151 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care (Licence: NY 281672) |
| Enumeration Date | 2016-04-05 |
| Last Update Date | 2016-04-05 |