Nids Coalition Northern Chapter | |
103 S Main St Black River NY 13612-2101 | |
(315) 773-5405 | |
(315) 773-5378 |
Full Name | Nids Coalition Northern Chapter |
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Speciality | General Practice |
Location | 103 S Main St, Black River, New York |
Authorized Official Name and Position | Katherine Robertson (DIRECTOR) |
Authorized Official Contact | 3157735405 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Nids Coalition Northern Chapter 103 S Main St Black River NY 13612-2101 Ph: (315) 773-5405 | Nids Coalition Northern Chapter 103 S Main St Black River NY 13612-2101 Ph: (315) 773-5405 |
NPI Number | 1114178001 |
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Provider Enumeration Date | 10/09/2008 |
Last Update Date | 10/09/2008 |
Identifier | Type | State | Issuer |
---|---|---|---|
1114178001 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208D00000X | General Practice | (* (Not Available)) | Primary |