JOSE M FONSECA

BRONX, NY
NPI1003560947
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: NY  20930)
Enumeration Date2022-02-09
Last Update Date2022-02-09
Business Address
JOSE M FONSECA CASAC
1776 CLAY AVE
BRONX, NY 10457-7299
Phone number: 718-960-7599
Mailing Address
JOSE M FONSECA CASAC
311 E 175TH ST
BRONX, NY 10457-5848
Phone number: 718-960-7568
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