JACK L UNDERWOOD (NPI# 1376530410) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376530410 |
| Entity Type | Individual |
| Full Name | JACK L UNDERWOOD |
| Credential | MD |
| Practice Address |
1565 Union St Schenectady NY 12309-6022 |
| Mailing Address |
1565 Union St Schenectady NY 12309-6047 |
| Practice Telephone | 5183745640 |
| Practice Fax Number | 4133755640 |
| Mailing Telephone | 5183745640 |
| Mailing Fax Number | 4133755640 |
| Enumeration Date | 2005-10-04 |
| Last Update Date | 2008-09-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
082748 | NY | Allopathic & Osteopathic Physicians |
| N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
4968 | AK | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AK | LICENSE | 4968 | 01 |
| NY | 00525957 | 05 | |
| AK | MD0812 | 05 | |
| VA | LICENSE | 0101222023 | 01 |
| NY | LICENSE | 082748 | 01 |
| NM | LICENSE | 93-416 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215373485 | Jack Underwood | Counselor | 3108 Piedmont Rd Ne, Atlanta, GA 30305-2513 | 2013-05-15 |
| Street Address |
1565 UNION ST |
| City | SCHENECTADY |
| State | NY |
| Zip Code | 12309-6022 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154973071 | Albany Med Niskayuna Ambulatory Endoscopy and Surgery Center | Clinic/Center | 1769 Union Street, 3rd Floor, Niskayana, NY 12309 | 2019-07-11 |
| 1902396351 | Erica S Hill | Occupational Therapist | 2246 Van Rensselaer Dr, Niskayuna, NY 12309 | 2018-05-11 |
| 1588107015 | Orthopedicsny, LLP | Orthopaedic Surgery | 1760 Union St, Suite 100, Schenectady, NY 12309 | 2016-12-01 |
| 1932589983 | Patricia P Primomo | Dentist | 2310 Nott Street East, Niskayuna, NY 12309 | 2015-06-04 |
| 1386074268 | Bernard P Kinlan | Social Worker | 1 Ascot Lane, Terrace At Glen Eddy, Niskayuna, NY 12309 | 2013-11-14 |
| 1255680344 | Rudy Nydegger Phd, Abpp, Pllc | Psychologist | 2317 Balltown Rd., Suite 203, Schenectady, NY 12309 | 2012-09-05 |
| 1407104094 | Rachelle Ann Kehoe | Specialist | 950 St. David's Lane, Schenectady, NY 12309 | 2012-08-29 |
| 1073882726 | Kristina Lynn Deangelo | Speech-Language Pathologist | 1872 Hexam Road West, Niskayuna, NY 12309 | 2011-12-27 |
| 1467720136 | Jjm Chiropractic, LLC | Chiropractor | 1756 Union St., Niskayuna, NY 12309 | 2011-12-08 |
| 1659658474 | Richard W Glover | Dentist | 2310 Nott St. East, Niskayuna, NY 12309 | 2011-11-08 |
| Find all providers in zip 12309 | ||||
| Taxonomy Code | 2084P0800X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Psychiatry |
| A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285082164 | Jeffrey M Brown | Psychiatry & Neurology | 1101 Nott St # 12308, Schenectady, NY 12308-2425 | 2016-06-01 |
| 1902931066 | Tri City Psych Medical Serives PC | Psychiatry & Neurology | 917 Nott St, Schenectady, NY 12308-2318 | 2007-02-22 |
| 1487718185 | Brian George Pell | Psychiatry & Neurology | 1839 Elizabeth St, Schenectady, NY 12303-4039 | 2006-12-20 |
| 1932151784 | Cindy Ann Guadagno | Psychiatry & Neurology | 1311 Union St, Schenectady, NY 12308-2905 | 2006-05-17 |
| 1770556870 | Gurkirpal S. Nijjar | Psychiatry & Neurology | 2082 Orchard Park Dr, Schenectady, NY 12309-2237 | 2006-02-09 |
| 1689932956 | Adriana M. Vannucci | Psychiatry & Neurology | 1101 Nott St, Department of Psychiatry, Schenectady, NY 12308-2425 | 2012-04-24 |
| 1952628133 | Elmer Luis Quintero | Psychiatry & Neurology | 1101 Nott St, Department of Psychiatry, Schenectady, NY 12308-2425 | 2010-04-27 |
| 1316143613 | Yousuf N. Ahmad | Psychiatry & Neurology | 1101 Nott St, Schenectady, NY 12308-2425 | 2007-06-23 |
| 1386847366 | Raquel Gil | Psychiatry & Neurology | 600 Franklin St, Suite 202, Schenectady, NY 12305 | 2007-06-07 |
| 1285853507 | Beatrice M Kovasznay | Psychiatry & Neurology | 1101 Nott St, Dept of Psychiatry, Schenectady, NY 12308-2425 | 2007-04-25 |
| Find all providers in SCHENECTADY | ||||
| City | SCHENECTADY |
| Zip Code | 12309 |
Please comment or provide details below to improve the information on JACK L UNDERWOOD.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.