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General NPI Number Information
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NPI Number | 1831157775
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Entity Type | Organization
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Legal Business Name | PSYCHIATRIC SERVICES OF CENTRAL NEW YORK
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Dates
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Enumeration Date | 05/02/2006
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Last Update Date | 12/11/2009
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Provider Practice Location Address
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Address Line | 502 COURT ST SUITE 204
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City | UTICA
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State | NY
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Zip | 13502-4233
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Country | US
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Telephone | 315-792-7626
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Fax | 315-792-7675
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Provider Business Mailing Address
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Address Line | 502 COURT ST SUITE 204
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City | UTICA
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State | NY
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Zip | 13502-4233
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Country | US
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Telephone | 315-792-7626
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Fax | 315-792-7675
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ELIZABETH A FARNUM
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Credential | MD
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Telephone | 315-792-7626
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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 | 209158
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License Number State | NY
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