| NPI | 1942767066 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMUEL WALTERS Owner/Md 845-721-1848 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty |
| 261QP2000X Clinic/Center, Physical Therapy | |
| 261QP2300X Clinic/Center, Primary Care | |
| Enumeration Date | 2019-02-25 |
| Last Update Date | 2019-02-25 |