| NPI | 1982974358 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN DANIEL COLINO Owner 315-724-6144 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 335944) |
| Enumeration Date | 2012-01-03 |
| Last Update Date | 2019-03-20 |