| NPI | 1801040126 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIDANIELLE D. ANNICCHIARICO Director 845-566-4595 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NY 005535-1) |
| Enumeration Date | 2008-11-13 |
| Last Update Date | 2008-11-13 |