| Professional Practice Group, Dept. Of Psych | |
|
750 E Adams St Syracuse NY 13210-2306 | |
| (315) 464-3119 | |
| (315) 464-3282 |
| Full Name | Professional Practice Group, Dept. Of Psych |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 750 E Adams St, Syracuse, New York |
| Authorized Official Name and Position | Mantosh J Dewan (PRESIDENT) |
| Authorized Official Contact | 3154643119 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Professional Practice Group, Dept. Of Psych 750 E Adams St Syracuse NY 13210-2306 Ph: (315) 464-3119 | Professional Practice Group, Dept. Of Psych 750 E Adams St Syracuse NY 13210-2306 Ph: (315) 464-3119 |
| NPI Number | 1710929047 |
|---|---|
| Provider Enumeration Date | 06/12/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710929047 | NPI | - | NPPES |
| 00570654 | Medicaid | NY |
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