| NPI | 1518231455 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAWARAN BAMBRAH President 716-488-0776 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: NY 116091) |
| Enumeration Date | 2012-02-23 |
| Last Update Date | 2012-02-23 |