| NPI | 1518190453 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAOUF KODSY President 315-736-0155 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine (Licence: NY 200560-1) |
| Enumeration Date | 2009-08-26 |
| Last Update Date | 2013-02-18 |