NPI | 1790974269 |
---|---|
Entity Type | Organization |
Authorized Contact | KOMAL CHANDAN Physician 716-298-4050 |
Organization Subpart ? | No |
Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: NY 189392) |
Enumeration Date | 2007-10-19 |
Last Update Date | 2012-01-03 |