Individual
TIMOTHY GANG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
400 SUNRISE HWY, CARONE HALL, AMITYVILLE, NY 11701-2508
(631) 608-5022
(631) 264-4509
Mailing address
400 SUNRISE HWY, CARONE HALL, AMITYVILLE, NY 11701-2508
(631) 608-5022
(631) 264-4509
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
25069-T
NY
Other
Enumeration date
01/24/2013
Last updated
01/24/2013
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