| NPI | 1649678780 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL W. ELICE Medical Director 506-802-5028 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207KA0200X Allergy & Immunology Allergy (Licence: NY 1325791) |
| Enumeration Date | 2014-12-05 |
| Last Update Date | 2014-12-05 |