| NPI | 1629351903 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH P FUSELLA Site Medical Director 518-346-3222 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 174880) |
| Enumeration Date | 2011-09-23 |
| Last Update Date | 2011-09-23 |