| NPI | 1942583554 |
|---|---|
| Doing Business As | FAMILY PRACTICE GREAT OAKS |
| Entity Type | Organization |
| Authorized Contact | DEBBY COONS Credentialing Manager 518-213-0478 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Enumeration Date | 2011-09-21 |
| Last Update Date | 2018-05-31 |