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General NPI Number Information
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NPI Number | 1902931066
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Entity Type | Organization
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Legal Business Name | TRI CITY PSYCH MEDICAL SERIVES PC
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Dates
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Enumeration Date | 02/22/2007
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Last Update Date | 11/02/2007
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Provider Practice Location Address
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Address Line | 917 NOTT ST
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City | SCHENECTADY
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State | NY
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Zip | 12308-2318
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Country | US
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Telephone | 518-382-9116
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Fax |
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Provider Business Mailing Address
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Address Line | 917 NOTT ST
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City | SCHENECTADY
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State | NY
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Zip | 12308-2318
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Country | US
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Telephone | 518-382-9116
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. GURKIRPAL S NIJJAR
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Credential | MD
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Telephone | 518-382-9116
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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 | 163978
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License Number State | NY
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