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Individual

MR. ERROLL SAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CASAC

Contact information

Practice address
380 NASSAU RD, ROOSEVELT, NY 11575-1343
(516) 623-7741
(516) 623-7775
Mailing address
102 COOLIDGE AVE, AMITYVILLE, NY 11701-2453
(516) 623-7741
(516) 623-7775

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
18871
NY

Other

Enumeration date
12/13/2013
Last updated
12/13/2013
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