| NPI | 1821178682 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOANNE MARIE FOGARTY Owner 518-783-1445 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: NY 195064) |
| Enumeration Date | 2006-10-16 |
| Last Update Date | 2020-08-22 |