Individual
JEFFREY CARIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA
Contact information
Practice address
150 LAKE ST, ELMIRA, NY 14901-3401
(607) 737-5215
(607) 737-5219
Mailing address
150 LAKE ST, ELMIRA, NY 14901-3401
(607) 737-5215
(607) 737-5219
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
00642-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1336163963
—
NY
Enumeration date
04/19/2013
Last updated
01/21/2016
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