Individual
SALVATORE COSTANZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
155 INDIAN HEAD RD, COMMACK, NY 11725-2212
(631) 543-6200
Mailing address
4 HINDES CT, SMITHTOWN, NY 11787-2508
(631) 366-3292
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
25265
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
25265
OASAS
NY
Enumeration date
05/28/2015
Last updated
05/28/2015
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