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1720290323
LIBERATO DEROSA
HUNTINGTON STATION, NY
NPI
1720290323
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: NY 9207)
Enumeration Date
2007-05-04
Last Update Date
2007-07-08
Business Address
Mr. LIBERATO DEROSA C.A.S.A.C.
2075 NEW YORK AVE
HUNTINGTON STATION, NY 11746-3238
Phone number: 631-351-7112
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Mailing Address
Mr. LIBERATO DEROSA C.A.S.A.C.
2226 1ST AVE
RONKONKOMA, NY 11779-6239
Phone number: 631-445-5373
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