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1487801650
MARTIN IRVING COLAVITO
PORT JERVIS, NY
NPI
1487801650
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor Addiction (Substance Use Disorder)
(Licence: NY 7929)
Enumeration Date
2008-08-19
Last Update Date
2008-08-19
Business Address
MARTIN IRVING COLAVITO CASAC
17-19 SUSSEX STREET
PORT JERVIS, NY 12771-2430
Phone number: 845-856-6344
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Mailing Address
MARTIN IRVING COLAVITO CASAC
17-19 SUSSEX STREET
PORT JERVIS, NY 12771-2430
Phone number: 845-856-6344
Copy
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