Individual
MATTHEW LUNDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CASAC-T
Contact information
Practice address
3584 JEROME AVE, BRONX, NY 10467-1006
(718) 653-1537
(718) 882-1426
Mailing address
79 GLENRIDGE RD, GLENVILLE, NY 12302-4523
(518) 952-8408
(518) 952-8287
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
31531
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01420795
—
NY
Enumeration date
10/08/2015
Last updated
02/28/2017
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