| NPI | 1629286265 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SALLY ROUSSEAU Clinical Associate 585-506-9484 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: NY 000449-1) |
| Enumeration Date | 2007-05-18 |
| Last Update Date | 2020-08-22 |