Individual
LUIS SUAREZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MHC
Contact information
Practice address
34 ONTARIO ST, PORT JEFFERSON STATION, NY 11776-4349
(631) 428-7639
Mailing address
34 ONTARIO ST, PORT JEFFERSON STATION, NY 11776-4349
(631) 428-7639
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
07/02/2016
Last updated
03/07/2019
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