Organization
PLATTSBURGH STATE UNIVERSITY
Active
Parent organization
STATE UNIVERSITY OF NEW YORK COLLEGE AT PLATTSBURGH
Other names
North Country Regional TBI Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
STATE UNIVERSITY OF NEW YORK COLLEGE AT PLATTSBURGH
Authorized official
MR. MICHAEL EDWIN SIMPSON (DIRECTOR OF SPONSORED RESEARCH)
(518) 564-2155
Entity
Organization
Contact information
Practice address
101 BROAD ST, BEAMONT 404, PLATTSBURGH, NY 12901-2637
(518) 564-2155
Mailing address
101 BROAD ST, KEHOE 815, PLATTSBURGH, NY 12901-2637
(518) 564-2155
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
013297
NY
103T00000X
Psychologist
013297
NY
Other
Enumeration date
11/18/2011
Last updated
11/18/2011
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