Consultation Services Of Central New York - Medicine Provider, Pllc | |
7030 E Genesee St Suite 109 Fayetteville NY 13066-1121 | |
(315) 560-6919 | |
Not Available |
Full Name | Consultation Services Of Central New York - Medicine Provider, Pllc |
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Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
Location | 7030 E Genesee St, Fayetteville, New York |
Authorized Official Name and Position | Matthew Henry Rosa (OWNER) |
Authorized Official Contact | 3155606919 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Consultation Services Of Central New York - Medicine Provider, Pllc 7030 E Genesee St Suite 109 Fayetteville NY 13066-1121 Ph: (315) 560-6919 | Consultation Services Of Central New York - Medicine Provider, Pllc 7030 E Genesee St Suite 109 Fayetteville NY 13066-1121 Ph: (315) 560-6919 |
NPI Number | 1205089992 |
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Provider Enumeration Date | 10/28/2008 |
Last Update Date | 10/28/2008 |
Identifier | Type | State | Issuer |
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1205089992 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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