Organization
KELBERMAN CENTER, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARYANN FATATA (HEALTH MANAGEMENT SYSTEMS SPECIALIS)
(315) 927-2117
Entity
Organization
Contact information
Practice address
2608 GENESEE ST, UTICA, NY 13502-6003
(315) 797-6421
(315) 749-7054
Mailing address
2608 GENESEE ST, UTICA, NY 13502-6003
(315) 797-6241
(315) 794-7054
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
103TC0700X
Clinical Psychologist
Primary
—
—
1041C0700X
Clinical Social Worker
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04587431
—
NY
Enumeration date
11/21/2017
Last updated
04/11/2018
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