Psychological Services For Self And Family, Pllc | |
523 E Genesee St Fayetteville NY 13066-1536 | |
(315) 637-9131 | |
(315) 637-9151 |
Full Name | Psychological Services For Self And Family, Pllc |
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Speciality | Psychologist |
Location | 523 E Genesee St, Fayetteville, New York |
Authorized Official Name and Position | Paul M. Cohen (OWNER) |
Authorized Official Contact | 3156379131 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Psychological Services For Self And Family, Pllc 523 E Genesee St Fayetteville NY 13066-1536 Ph: (315) 637-9131 | Psychological Services For Self And Family, Pllc 523 E Genesee St Fayetteville NY 13066-1536 Ph: (315) 637-9131 |
NPI Number | 1417260571 |
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Provider Enumeration Date | 07/19/2010 |
Last Update Date | 07/19/2010 |
Medicare PECOS PAC ID | 1153502257 |
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Medicare Enrollment ID | O20110223000165 |
Identifier | Type | State | Issuer |
---|---|---|---|
1417260571 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
103T00000X | Psychologist | 009823-1 (New York) | Primary |
Provider Name | Paul M Cohen |
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Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1134143951 PECOS PAC ID: 0446252621 Enrollment ID: I20070201000489 |
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