Organization
NIDS COALITION NORTHERN CHAPTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KATHERINE ROBERTSON RN,C,MSN (DIRECTOR)
(315) 773-5405
Entity
Organization
Contact information
Practice address
103 S MAIN ST, BLACK RIVER, NY 13612-2101
(315) 773-5405
(315) 773-5378
Mailing address
103 S MAIN ST, BLACK RIVER, NY 13612-2101
(315) 773-5405
(315) 773-5378
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
10/09/2008
Last updated
10/09/2008
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