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Organization
WESTERN NEW YORK MED-PSYCH PLLC
Active
Organization
WESTERN NEW YORK MED-PSYCH PLLC
Active
Parent organization
WESTERN NEW YORK MED-PSYCH PLLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
WESTERN NEW YORK MED-PSYCH PLLC
Authorized official
SAMPATH NEERUKONDA M.D. (M.D.)
(607) 324-1263
Entity
Organization
Contact information
Practice address
476 CANISTEO ST, HORNELL, NY 14843-9768
(607) 324-3580
(607) 324-3998
Mailing address
111 E 14TH ST, ELMIRA HEIGHTS, NY 14903-1303
(607) 734-9539
(607) 734-6293
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01488462
—
NY
Enumeration date
08/10/2006
Last updated
03/26/2009
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