Provider Demographics
NPI:1194192880
Name:GEORGE, CARRIE LYNN (PMHNP)
Entity type:Individual
Prefix:MS
First Name:CARRIE
Middle Name:LYNN
Last Name:GEORGE
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:MS
Other - First Name:CARRIE
Other - Middle Name:LYNN
Other - Last Name:CITRIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PMHNP
Mailing Address - Street 1:CENTRAL NEW YORK PSYCHIATRIC CENTER
Mailing Address - Street 2:9005 OLD RIVER RD. (PO BOX 300)
Mailing Address - City:MARCY
Mailing Address - State:NY
Mailing Address - Zip Code:13403
Mailing Address - Country:US
Mailing Address - Phone:315-765-3660
Mailing Address - Fax:315-765-3629
Practice Address - Street 1:CENTRAL NEW YORK PSYCHIATRIC CENTER
Practice Address - Street 2:9005 OLD RIVER RD.
Practice Address - City:MARCY
Practice Address - State:NY
Practice Address - Zip Code:13403
Practice Address - Country:US
Practice Address - Phone:315-765-3600
Practice Address - Fax:315-765-3629
Is Sole Proprietor?:No
Enumeration Date:2015-08-28
Last Update Date:2022-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY401893363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health