NPI | 1508456708 |
---|---|
Doing Business As | LATHAM COVID VACCINE CENTER |
Entity Type | Organization |
Authorized Contact | DEBBY COONS Credentialing Manager 518-213-0478 |
Organization Subpart ? | No |
Primary Taxonomy | 207R00000X Internal Medicine |
Additional Taxonomies | 207Q00000X Family Medicine |
207V00000X Obstetrics & Gynecology | |
208000000X Pediatrics | |
2085R0202X Radiology, Diagnostic Radiology | |
208600000X Surgery | |
208D00000X General Practice | |
Enumeration Date | 2021-01-21 |
Last Update Date | 2022-07-29 |