LIFESPAN NP PSYCHIATRIC SERVICES PC NPI 1003629403

NPI Information

  • NPI: 1003629403
  • Provider Name: LIFESPAN NP PSYCHIATRIC SERVICES, PC
  • Classification: Nurse Practitioner - 363LP0808X
  • Specialization: Psychiatric/Mental Health
  • Entity Type: Organization
  • Address: 60 E STATE ST STE 400
    SHERRILL, NY
    ZIP 13461
  • Phone: (315) 200-9723

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NPI Details

LIFESPAN NP PSYCHIATRIC SERVICES, PC is a psychiatric/mental health nurse practitioner in Sherrill, NY. LIFESPAN NP PSYCHIATRIC SERVICES, PC NPI is 1003629403. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

60 E STATE ST STE 400
SHERRILL, NY
ZIP 13461-218
Phone: (315) 200-9723

The provider's authorized official is Kelly Dorman .
The authorized official title is Owner, President and has the following contact phone number (315) 200-9723.

The enumeration date for this NPI number is 1/29/2025 and was last updated on 1/29/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LP0808XNurse PractitionerPsychiatric/Mental HealthYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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