| Gfn Psychological Services, Pc | |
|
6701 Manlius Center Rd Suite 111-192 East Syracuse NY 13057-2999 | |
| (315) 218-6377 | |
| (315) 218-6377 |
| Full Name | Gfn Psychological Services, Pc |
|---|---|
| Speciality | Clinic/Center |
| Location | 6701 Manlius Center Rd, East Syracuse, New York |
| Authorized Official Name and Position | Theodore M Nnaji (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 9373045930 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gfn Psychological Services, Pc 6701 Manlius Center Rd Suite 111-192 East Syracuse NY 13057-2999 Ph: (315) 218-6377 | Gfn Psychological Services, Pc 6701 Manlius Center Rd Suite 111-192 East Syracuse NY 13057-2999 Ph: (315) 218-6377 |
| NPI Number | 1881991529 |
|---|---|
| Provider Enumeration Date | 02/15/2011 |
| Last Update Date | 02/15/2011 |
| Medicare PECOS PAC ID | 1456538990 |
|---|---|
| Medicare Enrollment ID | O20110622000132 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881991529 | NPI | - | NPPES |
| 1154623395 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | 018892 (New York) | Primary |
| Provider Name | Theodore M Nnaji |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1154623395 PECOS PAC ID: 2365629805 Enrollment ID: I20110622000175 |
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