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PROFESSIONAL PRACTICE GROUP DEPT. OF PSYCH NPI 1710929047


NPI Information

NPI: 1710929047
Provider Name: PROFESSIONAL PRACTICE GROUP, DEPT. OF PSYCH
Classification: Psychiatry & Neurology - 2084P0800X
Entity Type: Organization

Specialization: Psychiatry

Address:
750 E ADAMS ST
SYRACUSE, NY
ZIP 13210
Phone: (315) 464-3119
Get Directions

PROFESSIONAL PRACTICE GROUP, DEPT. OF PSYCH is a psychiatry psychiatry neurology in Syracuse, NY. The provider is a Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems. PROFESSIONAL PRACTICE GROUP, DEPT. OF PSYCH NPI is 1710929047. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

750 E ADAMS ST
SYRACUSE, NY
ZIP 13210-306
Phone: (315) 464-3119
Fax: (315) 464-3282

The provider's authorized official is Mantosh J Dewan .
The authorized official title is President and has the following contact phone number (315) 464-3119.

The enumeration date for this NPI number is 6/12/2006 and was last updated on 8/22/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
12084P0800XPsychiatry & NeurologyPsychiatryYes
2103TC0700XPsychologistClinicalX
31041C0700XSocial WorkerClinicalX

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
100570654MEDICAIDNEW YORK

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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