| Suite E, Inc. | |
|
3209 Vestal Pkwy Suite E Vestal NY 13850-2154 | |
| (607) 729-3003 | |
| (607) 729-3004 |
| Full Name | Suite E, Inc. |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 3209 Vestal Pkwy, Vestal, New York |
| Authorized Official Name and Position | Jodi Sue Lowry (PRESIDENT) |
| Authorized Official Contact | 6077293003 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Suite E, Inc. 3209 Vestal Pkwy Suite E Vestal NY 13850-2154 Ph: (607) 729-3003 | Suite E, Inc. 3209 Vestal Pkwy Suite E Vestal NY 13850-2154 Ph: (607) 729-3003 |
| NPI Number | 1093909780 |
|---|---|
| Provider Enumeration Date | 09/05/2007 |
| Last Update Date | 09/05/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093909780 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | R053915 (New York) | Secondary |
| 261QM0850X | Clinic/center - Adult Mental Health | R053915 (New York) | Primary |
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Suresh Undavia, Md Pllc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 114 Clayton Ave, Vestal, NY 13850 Phone: 607-785-4277 Fax: 607-785-3617 |