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Contact Information

GENESEE STREET MEDICAL HEALTH
286 GENESEE ST STE 5
UTICA, NY13502
 Phone: 315-266-0600
 Fax: 315-266-0611
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Psychiatry

2084P0800X 26 Physician/Psychiatry
Indicates primary specialty

NPI Profile & details for GENESEE STREET MEDICAL HEALTH · (Female)

NPI # 1184138265
Status Active
Credentials
Entity Individual
Enumeration date 11/28/2017
Last updated 08/09/2018 - About 8 years ago
Sole proprietor 1 Not specified
Identifiers
  • NY License # 232467
  • NY Medicaid 04989199
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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