| NPI | 1881638658 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID SEVEY Managed Care Liaison 607-772-6904 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251V00000X Voluntary or Charitable (Licence: NY RID 1582;2330;2023;) |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2019-03-12 |