| NPI | 1982775441 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROLYN A BERRY Lpn 315-585-4445 |
| Organization Subpart ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: NY 124749-1) |
| Enumeration Date | 2006-11-13 |
| Last Update Date | 2008-06-13 |