| NPI | 1962673327 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HADI KOOHSARI Owner 518-374-1610 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: NY 208608) |
| Enumeration Date | 2008-03-13 |
| Last Update Date | 2008-03-13 |