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1962964510
DIANCO LAVENSKI HOLDER
KEW GARDENS, NY
NPI
1962964510
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: NY 33557)
Enumeration Date
2019-04-03
Last Update Date
2021-08-31
Business Address
DIANCO LAVENSKI HOLDER CASAC
8002 KEW GARDENS RD STE 704
KEW GARDENS, NY 11415-3607
Phone number: 718-520-1513
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Mailing Address
DIANCO LAVENSKI HOLDER CASAC
100 ACACIA AVE
HEMPSTEAD, NY 11550-7021
Phone number:
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