Individual
JERRY ROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CASAC 2
Contact information
Practice address
2015 MADISON AVE, NEW YORK, NY 10035-1015
(212) 690-4625
Mailing address
2015 MADISON AVE, NEW YORK, NY 10035-1015
(212) 690-4625
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
03/16/2017
Last updated
05/03/2024
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