Centre Syracuse, Llc | |
3300 James St Syracuse NY 13206-2387 | |
(315) 671-2202 | |
(315) 671-2203 |
Full Name | Centre Syracuse, Llc |
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Speciality | Community/Behavioral Health |
Location | 3300 James St, Syracuse, New York |
Authorized Official Name and Position | John Henry Wohlers (CEO) |
Authorized Official Contact | 3156712202 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Centre Syracuse, Llc 3300 James St Syracuse NY 13206-2387 Ph: (315) 671-2202 | Centre Syracuse, Llc 3300 James St Syracuse NY 13206-2387 Ph: (315) 671-2202 |
NPI Number | 1578682381 |
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Provider Enumeration Date | 03/29/2007 |
Last Update Date | 07/10/2017 |
Medicare PECOS PAC ID | 4789600669 |
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Medicare Enrollment ID | O20051020000146 |
Identifier | Type | State | Issuer |
---|---|---|---|
1578682381 | NPI | - | NPPES |
02745673 | Medicaid | NY |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
Provider Name | John H Wohlers |
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Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1225112071 PECOS PAC ID: 2264322916 Enrollment ID: I20051024000121 |
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