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UPSTATE KETAMINE CARE
NPI 1710522875
Clinical Nurse Specialist - Psychiatric/Mental Health in Rochester, NY

Active since November 13, 2019
3300 MONROE AVE STE 319, ROCHESTER, NY 14618(585) 673-2319 Get Directions Write a Review

NPPES record last updated: November 13, 2019. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Upstate Ketamine Care NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

UPSTATE KETAMINE CARE (NPI 1710522875) is a healthcare organization registered as a psychiatric/mental health in Rochester, New York and active in the NPI registry since November 2019. The organization lists Jeffrey C Leathersich, Practice Administrator, as its authorized official.

NPPES Registry Identity

NPI1710522875
Entity TypeOrganization
Primary Taxonomy364SP0808X
Legal Business NameUPSTATE KETAMINE CARE
Location Address3300 MONROE AVE STE 319Rochester, NY 14618-4617
Mailing Address3300 Monroe Ave Ste 319Rochester, NY 14618-4617 · (585) 673-2319
Phone(585) 673-2319
Organization SubpartNo
Authorized OfficialJeffrey C LeathersichPractice Administrator · (585) 673-2319
Enumeration DateNovember 13, 2019
✔ NPI 1710522875 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinical Nurse Specialist · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code364SP0808X
3300 MONROE AVE STE 319, Rochester, NY 14618
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Other Identifiers 1

Medicaid03426666NY

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Upstate Ketamine Care's NPI number?

The NPI number for Upstate Ketamine Care is 1710522875. It was assigned to this organization in the NPPES registry on November 13, 2019.

Where is Upstate Ketamine Care located?

Upstate Ketamine Care is located at 3300 Monroe Ave Ste 319, Rochester, NY 14618. The listed phone number is (585) 673-2319.

What is Upstate Ketamine Care's specialty?

The primary specialty registered for this NPI is Clinical Nurse Specialist, specializing in Psychiatric/Mental Health, with taxonomy code 364SP0808X.

When was this NPI record last updated?

The NPPES record for Upstate Ketamine Care was last updated on November 13, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.