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Individual

MR. THOMAS MACEDON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CASAC

Contact information

Practice address
273 HEBERTON AVE, STATEN ISLAND, NY 10302-1809
(718) 816-6589
Mailing address
273 HEBERTON AVE, STATEN ISLAND, NY 10302-1809
(718) 816-6589

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
9234
NY

Other

Enumeration date
01/09/2012
Last updated
01/09/2012
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