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General NPI Number Information
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NPI Number | 1609270248
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Entity Type | Organization
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Legal Business Name | CENTRAL NY PSYCHIATRIC CENTER
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Dates
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Enumeration Date | 10/10/2014
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Last Update Date | 10/10/2014
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Provider Practice Location Address
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Address Line | 9005 OLD RIVER RD
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City | MARCY
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State | NY
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Zip | 13403-3000
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Country | US
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Telephone | 315-765-3780
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Fax | 315-765-3789
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Provider Business Mailing Address
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Address Line | 9005 OLD RIVER RD PO BOX 300
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City | MARCY
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State | NY
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Zip | 13403-3000
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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 | DIRECTOR OF PHARMACY
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Name | JOE CIRILLO
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Credential |
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Telephone | 315-765-3781
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336I0012X
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Taxonomy Name | Institutional Pharmacy
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License Number | 016008
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License Number State | NY
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