Provider Demographics
NPI:1851331367
Name:SUBURBAN PSYCHIATRIC ASSOCIATES, LLP
Entity Type:Organization
Organization Name:SUBURBAN PSYCHIATRIC ASSOCIATES, LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FIANANCE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:HELEN
Authorized Official - Middle Name:B
Authorized Official - Last Name:PELYSKO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:716-689-3333
Mailing Address - Street 1:85 BRYANT WOODS S
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14228-3604
Mailing Address - Country:US
Mailing Address - Phone:716-689-3333
Mailing Address - Fax:716-689-9866
Practice Address - Street 1:85 BRYANT WOODS S
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14228-3604
Practice Address - Country:US
Practice Address - Phone:716-689-3333
Practice Address - Fax:716-689-9866
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY11937AMedicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER