| NPI | 1568952380 |
|---|---|
| Other Name | MECHANICVILLE FAMILY PRACTICE |
| Entity Type | Organization |
| Authorized Contact | GARY FOSTER VP/CFO 518-587-3222 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Enumeration Date | 2018-05-17 |
| Last Update Date | 2018-05-17 |