NPI | 1760727325 |
---|---|
Other Name | 63 SHAKER ROAD-SUITE 102 |
Entity Type | Organization |
Authorized Contact | PAUL GORDON Dir Fin/Admin Phys Enterprise 518-525-1585 |
Organization Subpart ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine |
Enumeration Date | 2012-12-07 |
Last Update Date | 2014-01-21 |