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MARTIN IRVING COLAVITO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CASAC

Contact information

Practice address
17-19 SUSSEX STREET, PORT JERVIS, NY 12771-2430
(845) 856-6344
(845) 856-4091
Mailing address
17-19 SUSSEX STREET, PORT JERVIS, NY 12771-2430
(845) 856-6344
(845) 856-4091

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
7929
NY

Other

Enumeration date
08/19/2008
Last updated
08/19/2008
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