Consultation Services of Central New York - Medicine Provider, PLLC

Organization Active NPI Mental Health Clinic/Center (Including Community Mental Health Center) · Fayetteville, NY

NPI 1205089992 · NPPES record last updated Oct 28, 2008

Key facts

NPI
1205089992
Entity type
Organization (NPI type 2)
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
Legal business name
CONSULTATION SERVICES OF CENTRAL NEW YORK - MEDICINE PROVIDER, PLLC
Practice address
7030 E Genesee St
Suite 109
Fayetteville, NY 13066-1121
Phone
(315) 560-6919
NPI assigned
Oct 28, 2008
Organization subpart
No

Authorized official

Name
Dr. Matthew Henry Rosa, M.D.
Title
Owner
Phone
(315) 560-6919

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Locations

7030 E Genesee St
Ste 109
Fayetteville, NY 13066
Phone (315) 510-6760

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Yes

Addresses

Primary practice location

7030 E Genesee St
Suite 109
Fayetteville, NY 13066-1121

Mailing address

7030 E Genesee St
Suite 109
Fayetteville, NY 13066-1121
Phone (315) 560-6919

Other providers in Fayetteville, NY

All providers in Fayetteville, NY · Mental Health Clinic/Center (Including Community Mental Health Center) in New York

Sources for this page

Verify at the official NPI Registry.