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7515 S State St Lowville NY 13367-1569 | |
(315) 376-0376 | |
(315) 376-0378 |
Full Name | |
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Speciality | Clinic/Center |
Location | 7515 S State St, Lowville, New York |
Authorized Official Name and Position | April E Diles (PSYCHIATRIC NURSE PRACTITIONER) |
Authorized Official Contact | 3153760376 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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7515 S State St Lowville NY 13367-1569 Ph: (315) 376-0376 | 7515 S State St Lowville NY 13367-1569 Ph: (315) 376-0376 |
NPI Number | 1548616949 |
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Provider Enumeration Date | 05/04/2016 |
Last Update Date | 05/04/2016 |
Medicare PECOS PAC ID | 9133410889 |
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Medicare Enrollment ID | O20160628000437 |
Identifier | Type | State | Issuer |
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1548616949 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QM0855X | Clinic/center - Adolescent And Children Mental Health | 401513 (New York) | Primary |
Provider Name | April E Diles |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1972852069 PECOS PAC ID: 3173753381 Enrollment ID: I20140310001781 |
Pathways Counseling Services, Llp Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 5402 Dayan St, Lowville, NY 13367 Phone: 315-804-0303 | |