| NPI | 1922048370 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANE MARIE STAMAS Credentialing Coordinator 518-782-3742 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 207U00000X Nuclear Medicine | |
| 207V00000X Obstetrics & Gynecology | |
| 208000000X Pediatrics | |
| 2085R0202X Radiology, Diagnostic Radiology | |
| 2085R0204X Radiology, Vascular & Interventional Radiology | |
| 208600000X Surgery | |
| 208D00000X General Practice | |
| Enumeration Date | 2006-06-07 |
| Last Update Date | 2024-03-27 |