| 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 |
|---|---|
| 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 |
|---|---|
| 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 |