Healthcare Provider Details

I. General information

NPI: 1992275481
Provider Name (Legal Business Name): HUTCHINGS PSYCHIATRIC CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/28/2018
Last Update Date: 11/28/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

620 MADISON STREET
SYRACUSE NY
13210
US

IV. Provider business mailing address

107 ASHFORD COURT
SYRACUSE NY
13211
US

V. Phone/Fax

Practice location:
  • Phone: 315-426-3600
  • Fax:
Mailing address:
  • Phone: 315-748-4353
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State

VIII. Authorized Official

Name: SARA L DIONNE
Title or Position: NURSE 1
Credential: RN
Phone: 315-748-4353