| NPI | 1821405226 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICIA BOSEN Director 518-580-5550 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: NY F333461) |
| Enumeration Date | 2014-07-17 |
| Last Update Date | 2014-07-17 |