Provider Demographics
NPI:1528706017
Name:PSYCHIATRIC WELLNESS GROUP
Entity type:Organization
Organization Name:PSYCHIATRIC WELLNESS GROUP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:A
Authorized Official - Last Name:LANDY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:585-218-0766
Mailing Address - Street 1:625 PANORAMA TRL STE 220
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14625-2432
Mailing Address - Country:US
Mailing Address - Phone:585-218-0766
Mailing Address - Fax:585-218-0765
Practice Address - Street 1:625 PANORAMA TRL STE 2220
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14625-2431
Practice Address - Country:US
Practice Address - Phone:585-218-0766
Practice Address - Fax:585-218-0765
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DOUGLAS A. LANDY MD PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-05-24
Last Update Date:2023-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty