| NPI | 1851358469 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WAYNE A EVANCOE Administrator 518-271-0702 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QE0700X Clinic/Center, End-Stage Renal Disease (ESRD) Treatment (Licence: NY 4102201R) |
| Enumeration Date | 2006-04-27 |
| Last Update Date | 2020-08-22 |