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General NPI Number Information
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NPI Number | 1528706017
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Entity Type | Organization
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Legal Business Name | PSYCHIATRIC WELLNESS GROUP
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Dates
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Enumeration Date | 05/24/2022
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Last Update Date | 08/04/2023
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Provider Practice Location Address
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Address Line | 625 PANORAMA TRL STE 2220
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City | ROCHESTER
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State | NY
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Zip | 14625-2431
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Country | US
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Telephone | 585-218-0766
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Fax | 585-218-0765
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Provider Business Mailing Address
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Address Line | 625 PANORAMA TRL STE 220
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City | ROCHESTER
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State | NY
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Zip | 14625-2432
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Country | US
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Telephone | 585-218-0766
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Fax | 585-218-0765
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Authorized Official
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Title or Position | OWNER
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Name | DR. DOUGLAS A. LANDY
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Credential | MD
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Telephone | 585-218-0766
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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