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NPI Code Detail

MEDICARE: MRS. CELESTE NEWBY CASAC-T

MEDICARE: MRS. CELESTE NEWBY CASAC-T
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) Counselor20909NY

General Provider Information

NPI Number : 1821218017
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. CELESTE NEWBY CASAC-T
Provider Business Mailing Address
First Line : 208 ROANOKE AVE
Second Line :
City : RIVERHEAD
State : NY
Zip : 11901-2706
Country : US
Telephone Number : 631-369-0104
Fax Number : 631-369-5433
Provider Business Practice Location Address
First Line : 208 ROANOKE AVE
Second Line :
City : RIVERHEAD
State : NY
Zip : 11901-2706
Country : US
Telephone Number : 631-369-0104
Fax Number : 631-369-5433
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/27/2007
Last Update Date : 03/15/2010

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Directions to “ MRS. CELESTE NEWBY CASAC-T” Practice Location

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