MEDICARE: JAMESTOWN PSYCHIATRIC PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0804X	Child & Adolescent Psychiatry Physician	254621	NY

General Provider Information

NPI Number	:	1700062247
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JAMESTOWN PSYCHIATRIC PC

Provider Business Mailing Address
First Line	:	1465 FOOTE AVENUE EXT
Second Line	:
City	:	JAMESTOWN
State	:	NY
Zip	:	14701-9383
Country	:	US
Telephone Number	:	716-526-4041
Fax Number	:	716-526-4161

Provider Business Practice Location Address
First Line	:	1465 FOOTE AVENUE EXT
Second Line	:
City	:	JAMESTOWN
State	:	NY
Zip	:	14701-9383
Country	:	US
Telephone Number	:	716-526-4041
Fax Number	:	716-526-4161

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. ISRAR A ABBASI
Credential	:	MD
Telephone Number	:	716-665-0929

Provider Enumeration Date	:	01/15/2008
Last Update Date	:	03/15/2023

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