Healthcare Provider Details

I. General information

NPI: 1932037900
Provider Name (Legal Business Name): ALEX DOUGLAS SAWICKI CASAC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2026
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

431 MEMORIAL PKWY
NIAGARA FALLS NY
14303-1407
US

IV. Provider business mailing address

4625 ISHERWOOD DR
NIAGARA FALLS NY
14305-1370
US

V. Phone/Fax

Practice location:
  • Phone: 716-284-6228
  • Fax: 716-284-1016
Mailing address:
  • Phone: 716-284-6228
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number42182
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: