NPI | 1770881245 |
---|---|
Doing Business As | SUNY DMC@LICH-FAMILY PRACTICE |
Entity Type | Organization |
Authorized Contact | MARILYN VIENTOS - SOTIRIADIS COO 718-270-2025 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine |
Additional Taxonomies | 207QA0000X Family Medicine, Adolescent Medicine |
207QA0401X Family Medicine, Addiction Medicine | |
207QG0300X Family Medicine, Geriatric Medicine | |
Enumeration Date | 2011-03-08 |
Last Update Date | 2013-04-04 |