| NPI | 1740384247 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FARRUKN ANWER Member 315-255-2255 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NY 213033) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 240389) |
| 363LP0200X Nurse Practitioner Pediatrics | |
| Enumeration Date | 2006-09-13 |
| Last Update Date | 2011-11-21 |