No | |
6607 Kinne Rd De Witt NY 13214-1871 | |
(315) 446-6406 | |
Not Available |
Full Name | No |
---|---|
Speciality | Clinic/center |
Location | 6607 Kinne Rd, De Witt, New York |
Authorized Official Name and Position | Praveen K Simlote (PRESIDENT) |
Authorized Official Contact | 3154466406 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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No 6607 Kinne Rd Dewitt NY 13214 Ph: (315) 446-6406 | No 6607 Kinne Rd De Witt NY 13214-1871 Ph: (315) 446-6406 |
NPI Number | 1417317041 |
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Provider Enumeration Date | 02/24/2016 |
Last Update Date | 02/24/2016 |
Identifier | Type | State | Issuer |
---|---|---|---|
1417317041 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | 035492 (New York) | Primary |