| NPI | 1740731793 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TEENA BUCHALTER Credentialing 845-230-5161 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 020094) |
| Enumeration Date | 2016-10-14 |
| Last Update Date | 2016-10-14 |