| NPI | 1619922218 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANE K CLARKE RN/Nurse Manager 518-399-7723 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 1678721) |
| Enumeration Date | 2006-05-23 |
| Last Update Date | 2020-08-22 |