| NPI | 1770642076 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RESITUTO ACOSTA Owner 315-337-2582 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0805X |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| Enumeration Date | 2006-12-06 |
| Last Update Date | 2025-09-11 |