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General NPI Number Information
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NPI Number | 1821491903
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Entity Type | Organization
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Legal Business Name | CENTRAL NEW YORK SERVICES, INC.
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Dates
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Enumeration Date | 10/02/2014
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Last Update Date | 10/02/2014
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Provider Practice Location Address
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Address Line | 321 W ONONDAGA ST
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City | SYRACUSE
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State | NY
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Zip | 13202-3207
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Country | US
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Telephone | 315-478-0610
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Fax |
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Provider Business Mailing Address
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Address Line | 5006 CORNISH HEIGHTS PKWY
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City | SYRACUSE
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State | NY
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Zip | 13215-2304
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Country | US
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Telephone | 315-478-0610
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Fax |
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Authorized Official
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Title or Position | ASSOCIATE DIRECTOR
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Name | MR. TOM MURPHY
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Credential | M.DIV., CASAC
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Telephone | 315-478-0610
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number | 281402-1
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License Number State | NY
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