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General NPI Number Information
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NPI Number | 1760661870
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Entity Type | Organization
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Legal Business Name | CENTRAL NEW YORK PSYCHIATRIC CENTER FOR FORENSICS
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Dates
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Enumeration Date | 10/25/2007
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Last Update Date | 10/25/2007
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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 | 315-765-3600
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Fax |
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Provider Business Mailing 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 | 315-765-3600
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Fax |
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Authorized Official
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Title or Position | FACILITY DIRECTOR
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Name | DR. DON SAWYER
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Credential | PH.D.
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Telephone | 315-765-3600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 283Q00000X
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Taxonomy Name | Psychiatric Hospital
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License Number | F3030604
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License Number State | NY
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