| NPI | 1508863242 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOROTHY LISS ZIMDAHL Administrator 716-250-6520 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: NY 1401231R) |
| Enumeration Date | 2005-07-07 |
| Last Update Date | 2021-07-09 |