Professional Practice Group, Dept. Of Psych
LBN: Professional Practice Group, Dept. Of Psych
Professional Practice Group, Dept. Of Psych is an health care organization with primary practice located at 750 E Adams St , Syracuse NY 13210-2306. The organization recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Allopathic & Osteopathic Physicians / Psychiatry. Behavioral Health & Social Service Providers / Clinical is the primary health care specialty.
Professional Practice Group, Dept. Of Psych can be contacted via phone (315) 464-3119, or through Dewan, Mantosh J via phone (315) 464-3119.
Contact Information
Primary practice address
750 E Adams St
Syracuse NY 13210-2306
Phone: (315) 464-3119
Fax: (315) 464-3282
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | ||
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | ||
| Allopathic & Osteopathic Physicians / Psychiatry | 2084P0800X |
Profile Details
| NPI number | 1710929047 |
|---|---|
| LBN Legal business name | Professional Practice Group, Dept. Of Psych |
| DBA Doing business as | |
| Authorized official | Dewan, Mantosh J Doctor of Medicine (MD) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Jun 12th, 2006 |
| Last updated | Aug 22nd, 2020 - about 4 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1710929047 | NPPES |
| New York | MEDICAID | 00570654 |
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