| NPI | 1902960800 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUNIL RAM CEO 315-216-6687 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2006-12-22 |
| Last Update Date | 2022-04-04 |