Individual
RINI SIMON CHENNATTU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP-BC
Contact information
Practice address
165 MAIN ST, CORTLAND, NY 13045-3049
(845) 536-0732
Mailing address
165 MAIN ST, CORTLAND, NY 13045-3049
(845) 536-0732
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
402446
NY
Other
Enumeration date
09/26/2018
Last updated
09/26/2018
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