| Jamestown Psychiatric Pc | |
|
1465 Foote Avenue Ext Jamestown NY 14701-9383 | |
| (716) 526-4041 | |
| (716) 526-4161 |
| Full Name | Jamestown Psychiatric Pc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 1465 Foote Avenue Ext, Jamestown, New York |
| Authorized Official Name and Position | Israr A Abbasi (PRESIDENT) |
| Authorized Official Contact | 7166650929 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jamestown Psychiatric Pc 1465 Foote Avenue Ext Jamestown NY 14701-9383 Ph: (716) 526-4041 | Jamestown Psychiatric Pc 1465 Foote Avenue Ext Jamestown NY 14701-9383 Ph: (716) 526-4041 |
| NPI Number | 1700062247 |
|---|---|
| Provider Enumeration Date | 01/15/2008 |
| Last Update Date | 03/15/2023 |
| Certification Date | 03/15/2023 |
| Medicare PECOS PAC ID | 0244314631 |
|---|---|
| Medicare Enrollment ID | O20080225000063 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700062247 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0804X | Psychiatry & Neurology - Child & Adolescent Psychiatry | 254621 (New York) | Primary |
| Provider Name | Frederick W Verdonik |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1942291968 PECOS PAC ID: 9133172539 Enrollment ID: I20050225000267 |
| Provider Name | Israr A Abbasi |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1518925437 PECOS PAC ID: 8325143266 Enrollment ID: I20070420000344 |
| Provider Name | Walter H Warriner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215911979 PECOS PAC ID: 8426120619 Enrollment ID: I20080703000159 |
| Provider Name | Kyle A Wiktor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326030495 PECOS PAC ID: 3476602129 Enrollment ID: I20090528000568 |
| Provider Name | Monir A Chaudhry |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1740334267 PECOS PAC ID: 8527144112 Enrollment ID: I20100828000000 |
| Provider Name | Kristine E Bailey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669653952 PECOS PAC ID: 4880876929 Enrollment ID: I20110310000122 |
| Provider Name | Shahnawaz Meer |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1922261080 PECOS PAC ID: 1254501059 Enrollment ID: I20110906000440 |
| Provider Name | Laurie A Fenton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053687186 PECOS PAC ID: 7012169741 Enrollment ID: I20121204000230 |
| Provider Name | Syed A Shamsi |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1982849659 PECOS PAC ID: 9739333923 Enrollment ID: I20130218000464 |
| Provider Name | Tammie L Deyoe |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1649518655 PECOS PAC ID: 7315187226 Enrollment ID: I20130717000014 |
| Provider Name | Holly J Wilkins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316356983 PECOS PAC ID: 6305068701 Enrollment ID: I20141120000753 |
| Provider Name | Rebekah M Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275801979 PECOS PAC ID: 0042534950 Enrollment ID: I20150126000848 |
| Provider Name | Adelia A Sazonov |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1871930701 PECOS PAC ID: 3678843885 Enrollment ID: I20170720002598 |
| Provider Name | Julie A Apperson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659530962 PECOS PAC ID: 5799045563 Enrollment ID: I20180216001260 |
| Provider Name | Casey T Brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255964268 PECOS PAC ID: 2466873336 Enrollment ID: I20200601001631 |
| Provider Name | Rachel E King |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780299495 PECOS PAC ID: 8224457684 Enrollment ID: I20201217000512 |
| Provider Name | Cassandra Brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750967709 PECOS PAC ID: 9537547195 Enrollment ID: I20220609002851 |
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