Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Professional Practice Group, Dept of Psych

Organization Clinical Psychologist · NPI 1710929047

Professional Practice Group, Dept of Psych is a Clinical Psychologist in Syracuse, New York. Registered with an NPI since 2006.

In the registry since
2006
Specialties on file
3

Practice location Address checks out

750 E Adams St
Syracuse, NY 13210-2306
Phone: (315) 464-3119
Fax: (315) 464-3282
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X
Clinical Psychologist Taxonomy 103TC0700X
Psychiatry Physician Taxonomy 2084P0800X

Record details

NPI number1710929047
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Mantosh Dewan — President · (315) 464-3119
NPI enumeratedJune 12, 2006
Last updated in NPPESSeptember 11, 2025
Mailing address750 E Adams St, Syracuse, NY 13210-2306

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