Healthcare Provider Details

I. General information

NPI: 1699244632
Provider Name (Legal Business Name): HUTCHINGS PSYHCIATRIC CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/20/2018
Last Update Date: 11/20/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

650 MADISON ST
SYRACUSE NY
13210-2319
US

IV. Provider business mailing address

620 MADISON ST
SYRACUSE NY
13210-2319
US

V. Phone/Fax

Practice location:
  • Phone: 315-426-3600
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number
License Number State

VIII. Authorized Official

Name: MARK CATTALANI
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 315-426-3600