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General NPI Number Information
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NPI Number | 1801674106
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Entity Type | Organization
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Legal Business Name | MINDFUL CONNECTIONS PSYCHIATRY PLLC
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Dates
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Enumeration Date | 09/18/2023
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Last Update Date | 11/04/2024
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Provider Practice Location Address
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Address Line | 8203 MAIN ST STE 2
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City | WILLIAMSVILLE
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State | NY
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Zip | 14221-6051
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Country | US
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Telephone | 716-219-3636
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Fax | 716-209-3680
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Provider Business Mailing Address
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Address Line | 2372 SWEET HOME RD STE 3
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City | AMHERST
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State | NY
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Zip | 14228-2330
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Country | US
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Telephone | 716-389-3267
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Fax | 716-639-1382
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Authorized Official
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Title or Position | OWNER
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Name | DR. BISWARUP MANOJKUMAR GHOSH
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Credential |
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Telephone | 716-219-3636
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number |
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License Number State |
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Taxonomy #4
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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 |
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Taxonomy #5
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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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