Organization
JR NURSE PRACTITIONER IN PSYCHIATRY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH EDICK PHD (HEALTHCARE ADMINISTRATOR)
(518) 788-7983
Entity
Organization
Contact information
Practice address
430 FRANKLIN ST STE 2304, SCHENECTADY, NY 12305-2018
(518) 788-7983
(866) 616-2109
Mailing address
99 HYDE BLVD, BALLSTON SPA, NY 12020-1607
(518) 368-1691
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
03/05/2025
Last updated
03/05/2025
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