Individual
ALYSSA VASTANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11 FARBER DR STE D, BELLPORT, NY 11713-1500
(631) 286-0700
Mailing address
51 STEVEN PL, CORAM, NY 11727-4500
(646) 203-1846
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
07/09/2025
Last updated
07/09/2025
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