| NPI | 1821535592 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANICE MACKE CFO 518-525-6931 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology |
| Additional Taxonomies | 208D00000X General Practice |
| 363A00000X Physician Assistant | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2017-01-19 |
| Last Update Date | 2017-01-19 |