| Four Winds - Saratoga Out-patient Psychiatric Service, P.c. | |
|
30 Crescent Ave Saratoga Springs NY 12866-5142 | |
| (518) 584-3600 | |
| Not Available |
| Full Name | Four Winds - Saratoga Out-patient Psychiatric Service, P.c. |
|---|---|
| Speciality | Psychologist |
| Location | 30 Crescent Ave, Saratoga Springs, New York |
| Authorized Official Name and Position | Barry Weinstein (CFO) |
| Authorized Official Contact | 9147638151 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Four Winds - Saratoga Out-patient Psychiatric Service, P.c. 30 Crescent Ave Saratoga Springs NY 12866-5142 Ph: (518) 584-3600 | Four Winds - Saratoga Out-patient Psychiatric Service, P.c. 30 Crescent Ave Saratoga Springs NY 12866-5142 Ph: (518) 584-3600 |
| NPI Number | 1336146901 |
|---|---|
| Provider Enumeration Date | 06/28/2005 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 2466403969 |
|---|---|
| Medicare Enrollment ID | O20050202000158 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336146901 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | (* (Not Available)) | Primary |
| Provider Name | Suzanne H Sumida |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1902982515 PECOS PAC ID: 3577554625 Enrollment ID: I20170627003262 |
| Provider Name | Natalie A Baldwin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841737624 PECOS PAC ID: 6507135894 Enrollment ID: I20170629001548 |
| Provider Name | Brett R Nelson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1386725786 PECOS PAC ID: 8527113901 Enrollment ID: I20170710000844 |
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