Individual
ANTHONY J. PETTINELLI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CASAC-T
Contact information
Practice address
25 WILLOWBROOK RD, QUEENSBURY, NY 12804-5882
(518) 926-7200
Mailing address
25 WILLOWBROOK RD, QUEENSBURY, NY 12804-5882
(518) 926-7200
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
38520
NY
Other
Enumeration date
08/06/2024
Last updated
08/06/2024
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