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General NPI Number Information
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NPI Number | 1285186916
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Entity Type | Organization
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Legal Business Name | BISMARCK NP PSYCHIATRIC SERVICES PLLC
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Dates
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Enumeration Date | 10/28/2016
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Last Update Date | 10/28/2016
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Provider Practice Location Address
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Address Line | 6221 ROUTE 31 SUITE 106
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City | CICERO
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State | NY
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Zip | 13039
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Country | US
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Telephone | 315-489-0347
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Fax |
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Provider Business Mailing Address
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Address Line | 6332 MATILDA GAGE
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City | CICERO
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State | NY
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Zip | 13039-7916
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | MS. VIOLET M BARUTI
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Credential | PMHNP
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Telephone | 713-382-5890
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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 |
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License Number State | NY
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