Organization
GERIATRIC PSYCHIATRY CONSULTANT, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GUERMAN ERMOLENKO MD (PRESIDENT)
(518) 229-0807
Entity
Organization
Contact information
Practice address
200 WASHINGTON AVENUE EXT, ALBANY, NY 12203-5335
(518) 229-0807
(866) 465-2338
Mailing address
PO BOX 627, GUILDERLAND, NY 12084-0627
(518) 229-0807
(866) 465-2338
Taxonomy
Speciality
Code
Description
License number
State
2084P0805X
Geriatric Psychiatry Physician
Primary
214765
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
J100000220
NGS MEDICARE PIN
NY
Enumeration date
02/26/2009
Last updated
11/19/2015
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