| NPI | 1609541051 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELSEY JUNTUNEN Office Manager 518-578-4749 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 207RI0200X Internal Medicine, Infectious Disease |
| 363LA2200X Nurse Practitioner, Adult Health | |
| Enumeration Date | 2021-08-09 |
| Last Update Date | 2021-08-09 |