Organization · Type 2 NPI
Nids Coalition Northern Chapter
General Practice Physician · Black River, NY
NPI number
1114178001
Active
Practice location
103 S Main St
Black River, NY 13612-2101
Fax (315) 773-5378
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| General Practice Physician Primary | 208D00000X | None listed |
General Practice Physician: A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.
About NPI 1114178001
Nids Coalition Northern Chapter's National Provider Identifier is 1114178001, issued on Oct 9, 2008. The primary taxonomy on file is General Practice Physician (208D00000X), and the practice location is in Black River, NY. The record was last updated on Oct 9, 2008.