| NPI | 1801203757 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY ELLEN DYER M.D. 845-255-0977 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: NY 2086491) |
| Enumeration Date | 2014-07-11 |
| Last Update Date | 2014-07-11 |