| Nurse Practitioner In Psychiatry | |
|
587 Main St Suite 110a New York Mills NY 13417-1431 | |
| (315) 723-6031 | |
| (315) 507-5823 |
| Full Name | Nurse Practitioner In Psychiatry |
|---|---|
| Speciality | Clinic/Center |
| Location | 587 Main St, New York Mills, New York |
| Authorized Official Name and Position | Robert Sharpe (PRESIDENT) |
| Authorized Official Contact | 3157236031 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Nurse Practitioner In Psychiatry #3 Mill 587 Main St Suite 110a New York Mills NY 13417-1431 Ph: (315) 723-6031 | Nurse Practitioner In Psychiatry 587 Main St Suite 110a New York Mills NY 13417-1431 Ph: (315) 723-6031 |
| NPI Number | 1730610510 |
|---|---|
| Provider Enumeration Date | 03/23/2017 |
| Last Update Date | 05/09/2017 |
| Medicare PECOS PAC ID | 6103103049 |
|---|---|
| Medicare Enrollment ID | O20170503000459 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730610510 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | F401417 (New York) | Primary |
| Provider Name | Robert D Sharpe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467733550 PECOS PAC ID: 4981861184 Enrollment ID: I20120627000003 |
Central New York Quest, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 587 Main St, Suite 108, New York Mills, NY 13417 Phone: 315-732-3431 Fax: 866-822-2343 |