Provider First Line Business Practice Location Address:
CENTRAL NEW YORK PSYCHIATRIC CENTER, OLD RIVER ROAD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MARCY
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
13403
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
315-765-3647
Provider Business Practice Location Address Fax Number:
315-765-3659
Provider Enumeration Date:
01/30/2008