| Geriatric Psychiatry Consultant, Pllc | |
|
200 Washington Avenue Ext Albany NY 12203-5335 | |
| (518) 229-0807 | |
| (866) 465-2338 |
| Full Name | Geriatric Psychiatry Consultant, Pllc |
|---|---|
| Speciality | Psychiatry & Neurology - Geriatric Psychiatry |
| Location | 200 Washington Avenue Ext, Albany, New York |
| Authorized Official Name and Position | Guerman Ermolenko (PRESIDENT) |
| Authorized Official Contact | 5182290807 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Geriatric Psychiatry Consultant, Pllc Po Box 627 Guilderland NY 12084-0627 Ph: (518) 229-0807 | Geriatric Psychiatry Consultant, Pllc 200 Washington Avenue Ext Albany NY 12203-5335 Ph: (518) 229-0807 |
| NPI Number | 1326288622 |
|---|---|
| Provider Enumeration Date | 02/26/2009 |
| Last Update Date | 11/19/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326288622 | NPI | - | NPPES |
| J100000220 | Other | NY | NGS MEDICARE PIN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0805X | Psychiatry & Neurology - Geriatric Psychiatry | 214765 (New York) | Primary |
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