| NPI | 1609208982 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBBY COONS Credentialing Cooridnator 518-213-0478 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: NY 256381) |
| Enumeration Date | 2013-08-08 |
| Last Update Date | 2013-08-08 |