| NPI | 1730346115 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY D AMIDON Senior Member 315-225-3534 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 192498-1) |
| Enumeration Date | 2008-05-22 |
| Last Update Date | 2008-05-22 |