| NPI | 1710274360 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEVINA TALWAR Member 585-230-0186 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: NC 200901402) |
| Enumeration Date | 2011-07-04 |
| Last Update Date | 2011-07-04 |