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Individual

MR. PEDRO MAMOLAR

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CASAC-T

Contact information

Practice address
1064 FRANKLIN AVE, BRONX, NY 10456-6704
(718) 764-1593
(718) 764-1583
Mailing address
ACACIA NETWORK - BILLING DEPARTMENT, 311 EAST 175TH STREET, BRONX, NY 10457
(718) 960-7522
(718) 583-6439

Taxonomy

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

Other

Enumeration date
05/07/2025
Last updated
05/14/2025
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