Basic Information
| Provider Information | |||||||||
| NPI: | 1225307366 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | MOHAWK VALLEY PSYCHIATRIC CENTER | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1400 NOYES ST | ||||||||
| Address2: | |||||||||
| City: | UTICA | ||||||||
| State: | NY | ||||||||
| PostalCode: | 135023854 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3157383800 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1400 NOYES ST | ||||||||
| Address2: | |||||||||
| City: | UTICA | ||||||||
| State: | NY | ||||||||
| PostalCode: | 135023854 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3157383800 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 12/19/2011 | ||||||||
| LastUpdateDate: | 12/19/2011 | ||||||||
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| AuthorizedOfficialLastName: | SAWYER | ||||||||
| AuthorizedOfficialFirstName: | COLLEEN | ||||||||
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| AuthorizedOfficialTitleorPosition: | DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 3157383800 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | OFFICE OF MENTAL HEALTH NEW YORK STATE | ||||||||
| AuthorizedOfficialNamePrefix: | MS. | ||||||||
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| AuthorizedOfficialCredential: | RN | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251S00000X | 069656 | NY | Y | Agencies | Community/Behavioral Health |
No ID Information.