| NPI | 1861801862 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY ELLEN DYER Sole Proprietor 845-905-9389 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 208649) |
| Enumeration Date | 2014-08-05 |
| Last Update Date | 2024-10-02 |