| NPI | 1508898321 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN J WARREN Executive Director 315-478-2453 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center Multi-Specialty (Licence: NY 071111291) |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2008-09-12 |