| NPI | 1588360523 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRANDI L KELLER Contract Analyst 315-472-7504 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| 2085R0001X | |
| 363A00000X Physician Assistant | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2023-02-01 |
| Last Update Date | 2023-02-01 |