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Organization
PSYCHIATRY FACULTY PRACTICE, INC.
Active
Organization
PSYCHIATRY FACULTY PRACTICE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BARBARA A SVOBODA (PRACTICE PLAN ADMINISTRATOR)
(315) 464-3119
Entity
Organization
Contact information
Practice address
713 HARRISON ST, SYRACUSE, NY 13210-2305
(315) 464-3119
(315) 464-3282
Mailing address
713 HARRISON ST, SYRACUSE, NY 13210-2305
(315) 464-3119
(315) 464-3282
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
—
—
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00570654
—
NY
Enumeration date
01/29/2015
Last updated
01/29/2015
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