Individual
ASTRIDE ISMAEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
55 W AMES CT, PLAINVIEW, NY 11803-2304
(516) 448-2070
Mailing address
950 S OYSTER BAY RD, HICKSVILLE, NY 11801-3510
(516) 822-6111
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
276764308
—
NY
Enumeration date
07/21/2021
Last updated
10/01/2021
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