Individual
MR. LUIS ANGEL GARRASTEGUE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CASAC 24467
Contact information
Practice address
625 W 140TH ST, NEW YORK, NY 10031
(212) 690-6202
(212) 690-2757
Mailing address
2001 UNIVERSITY BLVD APT 5EW, BRONX, NY 10453-3977
(646) 369-3039
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
24467
NY
171M00000X
Case Manager/Care Coordinator
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02740141
—
NY
Enumeration date
05/19/2008
Last updated
08/30/2018
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