| NPI | 1548469661 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY LEVITZ Physician Assistant 518-561-0605 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NY 002093-1) |
| Enumeration Date | 2007-07-18 |
| Last Update Date | 2007-07-18 |