Organization
MEDICAL AND MENTAL HEALTH PRACTICE, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RESITUTO ACOSTA MD (OWNER)
(315) 337-2582
Entity
Organization
Contact information
Practice address
117 W LIBERTY ST, SUITE 2, ROME, NY 13440-5758
(315) 337-2582
Mailing address
117 W LIBERTY ST, SUITE 2, ROME, NY 13440-5758
(315) 337-2582
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
2084P0800X
Psychiatry Physician
—
—
2084P0805X
Geriatric Psychiatry Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02750012
—
NY
Enumeration date
12/06/2006
Last updated
09/11/2025
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