| NPI | 1568433142 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAWRENCE KEITH FOX Governing Body 845-471-3977 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: NY 1302209R) |
| Enumeration Date | 2006-01-31 |
| Last Update Date | 2015-03-12 |