| NPI | 1811074032 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORNA CORDELLLA FORBES Adminstrator 315-682-4212 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207VX0000X Obstetrics & Gynecology, Obstetrics (Licence: NY 1932051) |
| Additional Taxonomies | 207VX0000X Obstetrics & Gynecology, Obstetrics (Licence: NY 188409) |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2009-09-24 |