Organization
CREEDMOR PSYCHIATRIC CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SWAPNA DONEPUDI (PGY-1)
(985) 713-6141
Entity
Organization
Contact information
Practice address
7925 WINCHESTER BOULEVARD, CREEDMOOR PSYCHIATRIC CENTER MEDICAL EDUCATION, QUEENS VILLAGE, NY 11427
(718) 264-5030
Mailing address
3110 23RD ST, 5E, ASTORIA, NY 11106-4585
Taxonomy
Speciality
Code
Description
License number
State
273R00000X
Psychiatric Hospital Unit
—
—
283Q00000X
Psychiatric Hospital
Primary
—
—
Other
Enumeration date
11/30/2011
Last updated
11/30/2011
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