| NPI | 1578693917 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AHAMD M. MEHDI Dr 607-898-5827 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 215330-1) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 007106-1) |
| 363LF0000X Nurse Practitioner, Family | |
| Enumeration Date | 2007-03-06 |
| Last Update Date | 2020-01-16 |