Healthcare Provider Details
I. General information
NPI: 1720977820
Provider Name (Legal Business Name): VIHAAN BEHAVIORAL HEALTH FOR PSYCHIATRIC SERVICES, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/02/2025
Last Update Date: 07/02/2025
Certification Date: 07/02/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6836 E GENESEE ST STE C
FAYETTEVILLE NY
13066-1024
US
IV. Provider business mailing address
PO BOX 461
MANLIUS NY
13104-0461
US
V. Phone/Fax
- Phone: 315-925-6868
- Fax:
- Phone: 315-925-6868
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2084P0800X |
| Taxonomy | Psychiatry Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
TARUN
KUMAR
Title or Position: PARTNER
Credential: MD
Phone: 315-925-6868