| NPI | 1811290786 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CLARANCE B HENRY Medical Director/President 518-943-1442 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY F305407-1) |
| Enumeration Date | 2010-12-14 |
| Last Update Date | 2010-12-14 |