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1790055663
THOMAS MACEDON
STATEN ISLAND, NY
NPI
1790055663
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: NY 9234)
Enumeration Date
2012-01-09
Last Update Date
2012-01-09
Business Address
Mr. THOMAS MACEDON CASAC
273 HEBERTON AVE
STATEN ISLAND, NY 10302-1809
Phone number: 718-816-6589
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Mailing Address
Mr. THOMAS MACEDON CASAC
273 HEBERTON AVE
STATEN ISLAND, NY 10302-1809
Phone number: 718-816-6589
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