Provider Demographics
NPI:1164297776
Name:CNY MED MANAGEMENT
Entity Type:Organization
Organization Name:CNY MED MANAGEMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:M
Authorized Official - Last Name:TAUBERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:315-335-1285
Mailing Address - Street 1:207 STROUD ST
Mailing Address - Street 2:
Mailing Address - City:CANASTOTA
Mailing Address - State:NY
Mailing Address - Zip Code:13032-1425
Mailing Address - Country:US
Mailing Address - Phone:315-335-1285
Mailing Address - Fax:
Practice Address - Street 1:258 GENESEE ST STE 203
Practice Address - Street 2:
Practice Address - City:UTICA
Practice Address - State:NY
Practice Address - Zip Code:13502-4636
Practice Address - Country:US
Practice Address - Phone:315-335-1285
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-24
Last Update Date:2023-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Multi-Specialty