Upstate Ketamine Care

LBN: Upstate Ketamine Care
Upstate Ketamine Care is an health care organization with primary practice located at 3300 Monroe Ave Ste 319 , Rochester NY 14618-4617. The organization recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, which is considered as the primary health care specialty. Upstate Ketamine Care can be contacted via phone (585) 673-2319, or through Leathersich, Jeffrey C via phone (585) 673-2319.

Contact Information

Primary practice address
3300 Monroe Ave Ste 319 Rochester NY 14618-4617
Phone: (585) 673-2319
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Leathersich, Jeffrey C
Phone: (585) 673-2319

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 364SP0808X

Profile Details

NPI number 1710522875
LBN Legal business name Upstate Ketamine Care
DBA Doing business as
Authorized official Leathersich, Jeffrey C
Entity Organization
Organization subpart 1 No
Enumeration date Nov 13th, 2019
Last updated Nov 13th, 2019 - about 5 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1710522875 NPPES
New York MEDICAID 03426666

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