Provider Demographics
NPI:1083141964
Name:UPSTATE PSYCHIATRY
Entity Type:Organization
Organization Name:UPSTATE PSYCHIATRY
Other - Org Name:UPSTATE PSYCHIATRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MUHAMMAD
Authorized Official - Middle Name:
Authorized Official - Last Name:CHEEMA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:585-662-5945
Mailing Address - Street 1:115 SULLYS TRL STE 4
Mailing Address - Street 2:
Mailing Address - City:PITTSFORD
Mailing Address - State:NY
Mailing Address - Zip Code:14534-4571
Mailing Address - Country:US
Mailing Address - Phone:585-662-5945
Mailing Address - Fax:585-673-2181
Practice Address - Street 1:115 SULLYS TRL STE 4
Practice Address - Street 2:
Practice Address - City:PITTSFORD
Practice Address - State:NY
Practice Address - Zip Code:14534-4571
Practice Address - Country:US
Practice Address - Phone:585-662-5945
Practice Address - Fax:585-673-2181
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-22
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2337352084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty