| NPI | 1669972683 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BENJAMIN LEE COHEN Owner 585-820-9151 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 279199) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NY 006722) |
| 133V00000X Dietitian, Registered (Licence: NY 006206) | |
| Enumeration Date | 2018-02-16 |
| Last Update Date | 2019-06-11 |