| NPI | 1821485483 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARL M. COYLE Chief Executive Officer 315-425-1004 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: NY 3301227R) |
| Enumeration Date | 2015-04-22 |
| Last Update Date | 2016-11-17 |