Individual
MR. TYRONE ANTHONY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CASAC
Contact information
Practice address
110 EVANS AVE, FREEPORT, NY 11520-1435
(516) 546-4960
Mailing address
110 EVANS AVE, FREEPORT, NY 11520-1435
(516) 546-4960
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
2498
NY
Other
Enumeration date
04/23/2007
Last updated
07/08/2007
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