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Individual

DAVID JUAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
11 FARBER DRIVE, UNIT D, BELLPORT, NY 11713
(631) 286-0700
(631) 286-0688
Mailing address
11 FARBER DRIVE, UNIT D, BELLPORT, NY 11713

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
18907
NY

Other

Enumeration date
04/27/2007
Last updated
07/08/2007
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