| Kelberman Center, Inc | |
|
2608 Genesee St Utica NY 13502-6003 | |
| (315) 797-6241 | |
| (315) 749-7054 |
| Full Name | Kelberman Center, Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 2608 Genesee St, Utica, New York |
| Authorized Official Name and Position | Robert E. Myers (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 3157976241 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kelberman Center, Inc 1020 Mary St Utica NY 13501-1930 Ph: (315) 724-6907 | Kelberman Center, Inc 2608 Genesee St Utica NY 13502-6003 Ph: (315) 797-6241 |
| NPI Number | 1154779965 |
|---|---|
| Provider Enumeration Date | 06/02/2016 |
| Last Update Date | 06/02/2016 |
| Medicare PECOS PAC ID | 8921387887 |
|---|---|
| Medicare Enrollment ID | O20161116002132 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154779965 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (New York) | Primary |
| Provider Name | George K Tomy |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1265426480 PECOS PAC ID: 5395794705 Enrollment ID: I20050112000890 |
| Provider Name | Nicole M Derosa |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1427309228 PECOS PAC ID: 6608190673 Enrollment ID: I20150122000313 |
| Provider Name | Leah W. Welchons |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1477992626 PECOS PAC ID: 9436438306 Enrollment ID: I20161116002333 |
| Provider Name | Timothy Dempsey |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1902155740 PECOS PAC ID: 5698038321 Enrollment ID: I20180411001677 |
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