Organization
WOODBRIDGE NURSE PRACTITIONER IN PSYCHIATRY PLLC
Active
Other names
WOODBRIDGE PSYCHIATRY
Organization subpart
No
Provider details
NPI number
Authorized official
MR. OBOT OBOT NURSE PRACTITIONER (OWNER)
(716) 940-8565
Entity
Organization
Contact information
Practice address
680 DAVISON ROAD, LOCKPORT, NY 14094
(716) 940-8565
Mailing address
680 DAVISON ROAD, LOCKPORT, NY 14094
(716) 940-8565
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5179127
NYS DEPT OF STATE
NY
Enumeration date
09/17/2018
Last updated
09/17/2018
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