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Organization
PROFESSIONAL PSYCHIATRIC SERVICES P.C.
Active
Organization
PROFESSIONAL PSYCHIATRIC SERVICES P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANTHONY ANGELO RACANIELLO M.D. (PRESIDENT)
(716) 947-2097
Entity
Organization
Contact information
Practice address
6722 ERIE RD, DERBY, NY 14047-9670
(716) 947-2097
(716) 947-5909
Mailing address
6722 ERIE RD, PO BOX 803, DERBY, NY 14047-9670
(716) 947-2097
(716) 947-5909
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
188585
NY
2084P0802X
Addiction Psychiatry Physician
188585
NY
2084P0805X
Geriatric Psychiatry Physician
188585
NY
Other
Enumeration date
05/23/2006
Last updated
10/16/2012
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