Provider Demographics
NPI:1295175867
Name:MOHAWK VALLEY PSYCHIATRIC CENTER-YORK STREET CLINIC
Entity type:Organization
Organization Name:MOHAWK VALLEY PSYCHIATRIC CENTER-YORK STREET CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ARUN
Authorized Official - Middle Name:
Authorized Official - Last Name:PATIL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:315-738-4440
Mailing Address - Street 1:1400 NOYES STREET
Mailing Address - Street 2:
Mailing Address - City:UTICA
Mailing Address - State:NY
Mailing Address - Zip Code:13502
Mailing Address - Country:US
Mailing Address - Phone:315-738-4440
Mailing Address - Fax:
Practice Address - Street 1:1400 NOYES ST
Practice Address - Street 2:
Practice Address - City:UTICA
Practice Address - State:NY
Practice Address - Zip Code:13502-3854
Practice Address - Country:US
Practice Address - Phone:315-738-4440
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MOHAWK VALLEY PSYCHIATRIC CENTRE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-06-27
Last Update Date:2013-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY140953261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service