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General NPI Number Information
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NPI Number | 1881991529
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Entity Type | Organization
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Legal Business Name | GFN PSYCHOLOGICAL SERVICES, PC
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Dates
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Enumeration Date | 02/15/2011
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Last Update Date | 02/15/2011
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Provider Practice Location Address
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Address Line | 6701 MANLIUS CENTER RD SUITE 111-192
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City | EAST SYRACUSE
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State | NY
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Zip | 13057-2999
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Country | US
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Telephone | 315-218-6377
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Fax | 315-218-6377
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Provider Business Mailing Address
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Address Line | 6701 MANLIUS CENTER RD SUITE 111-192
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City | EAST SYRACUSE
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State | NY
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Zip | 13057-2999
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Country | US
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Telephone | 315-218-6377
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Fax | 315-218-6377
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | DR. THEODORE M NNAJI
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Credential | PSYD
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Telephone | 937-304-5930
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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 | 018892
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License Number State | NY
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