| NPI | 1619280914 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONALD S D'AMICO Podiatrist 315-445-0778 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: NY N002934) |
| Enumeration Date | 2010-07-15 |
| Last Update Date | 2010-07-15 |