is a Addiction (substance Use Disorder) in Bronx, New York. practices all healthcare services and medical treatments related to Addiction (substance Use Disorder). The NPI Number for is 1578720595. The last update date is .
's current location address is 2001 University Blvd Apt 5ew, Bronx, New York. You can contact this provider via phone number 6463693039. The mailing address for is 2001 University Blvd Apt 5ew, Bronx, New York. To know further, please read the information below!
Provider Profile Detail
| Provider Name | |
|---|---|
| Address | 2001 University Blvd Apt 5ew, Bronx, New York |
| Phone Number | 6463693039 |
| Fax Number | |
| Sole Proprietor | -- |
| Credentials | -- |
NPI Number Detail
| NPI Number | 1578720595 |
|---|---|
| Provider Enumeration Date | |
| Last Updated Date |
Provider Mailing Address Detail
| Address | 2001 University Blvd Apt 5ew |
|---|---|
| City | Bronx |
| State | New York (NY) |
| Post Code | 104533977 |
| Phone Number | 6463693039 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Addiction (substance Use Disorder) |
|---|---|
| Taxonomy | 101Ya0400X |
| Licence No | 24467 |
|
Definition: A counselor who helps people with alcohol, drug, gambling, internet, and other types of addictions. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 2740141 | NY | -- |
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