| Psychological Services For Self And Family, Pllc | |
|
523 E Genesee St Fayetteville NY 13066-1536 | |
| (315) 637-9131 | |
| (315) 637-9151 |
| Full Name | Psychological Services For Self And Family, Pllc |
|---|---|
| Speciality | Psychologist |
| Location | 523 E Genesee St, Fayetteville, New York |
| Authorized Official Name and Position | Paul M. Cohen (OWNER) |
| Authorized Official Contact | 3156379131 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Psychological Services For Self And Family, Pllc 523 E Genesee St Fayetteville NY 13066-1536 Ph: (315) 637-9131 | Psychological Services For Self And Family, Pllc 523 E Genesee St Fayetteville NY 13066-1536 Ph: (315) 637-9131 |
| NPI Number | 1417260571 |
|---|---|
| Provider Enumeration Date | 07/19/2010 |
| Last Update Date | 07/19/2010 |
| Medicare PECOS PAC ID | 1153502257 |
|---|---|
| Medicare Enrollment ID | O20110223000165 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417260571 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | 009823-1 (New York) | Primary |
| Provider Name | Paul M Cohen |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1134143951 PECOS PAC ID: 0446252621 Enrollment ID: I20070201000489 |
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