| NPI | 1619498516 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VISHNU P CHALLAPALLI Managing Member 585-203-7308 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX Q8702) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX Q7338) |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: TX Q8702) | |
| 2084P0805X (Licence: TX Q7338) | |
| Enumeration Date | 2017-06-29 |
| Last Update Date | 2021-06-17 |