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General NPI Number Information
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NPI Number | 1194192880
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Entity Type | Individual
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Provider Name | CARRIE LYNN GEORGE PMHNP
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Gender | Female
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Dates
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Enumeration Date | 08/28/2015
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Last Update Date | 01/28/2022
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Provider Practice Location Address
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Address Line | CENTRAL NEW YORK PSYCHIATRIC CENTER 9005 OLD RIVER RD.
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City | MARCY
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State | NY
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Zip | 13403
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Country | US
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Telephone | 315-765-3600
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Fax | 315-765-3629
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Provider Business Mailing Address
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Address Line | CENTRAL NEW YORK PSYCHIATRIC CENTER 9005 OLD RIVER RD. (PO BOX 300)
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City | MARCY
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State | NY
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Zip | 13403
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Country | US
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Telephone | 315-765-3660
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Fax | 315-765-3629
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 401893
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License Number State | NY
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