| Organization Name: | MARY KATHLEEN W DITURSI MD PC |
| NPI Number: | 1417391319 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MARY KATHLEEN W DITURSI (OWNER, PRESIDENT) |
| Mailing Address: | 55 Mohawk St Suite 101 Cohoes |
| State: | NY US |
| Postal Code: | 120472600 |
| Phone Number: | 5182339500 |
| Fax Number: | 5182354827 |
| NPI Enumeration Date: | 04/22/2013 |
| NPI Last Update Date: | 04/22/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2300X |
| License Number: | 263723 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Primary Care |
| Taxonomy Definition: | |