| NPI | 1790804599 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROL L. PUCEK Nurse Practitioner 845-227-6884 |
| Organization Subpart ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: NY 266501) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NY F400301) |
| Enumeration Date | 2007-03-29 |
| Last Update Date | 2020-08-22 |