| NPI | 1851465496 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHY A BIDWELL Billing Supervisor 315-752-0141 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: NY 124408) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: NY 145420) |
| 2082S0105X Plastic Surgery, Surgery of the Hand (Licence: NY 124408) | |
| 2082S0105X Plastic Surgery, Surgery of the Hand (Licence: NY 145420) | |
| Enumeration Date | 2006-11-17 |
| Last Update Date | 2015-01-29 |