| NPI | 1720222920 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANNE MARIE MORICI Credentialing COO Rdinator 518-348-1276 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NY 252830) |
| Enumeration Date | 2009-05-01 |
| Last Update Date | 2023-03-07 |