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 |