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1811595259
SAMUEL AUSTIN FORMANEK
NEW YORK, NY
NPI
1811595259
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: NY P107181)
Enumeration Date
2020-10-16
Last Update Date
2023-11-27
Business Address
Mr. SAMUEL AUSTIN FORMANEK
248 W 108TH ST
NEW YORK, NY 10025-2956
Phone number: 212-663-3000
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Mailing Address
Mr. SAMUEL AUSTIN FORMANEK
41 CORELL RD
SCARSDALE, NY 10583-7448
Phone number: 191-484-4297
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