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General NPI Number Information
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NPI Number | 1396333480
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Entity Type | Organization
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Legal Business Name | OYSTER BAY MENTAL HEALTH COUNSELING PLLC
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Dates
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Enumeration Date | 01/05/2021
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Last Update Date | 01/05/2021
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Provider Practice Location Address
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Address Line | 1035 JERICHO OYSTER BAY RD
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City | EAST NORWICH
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State | NY
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Zip | 11732-1049
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Country | US
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Telephone | 516-234-0541
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Fax |
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Provider Business Mailing Address
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Address Line | 97 SINGWORTH ST
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City | OYSTER BAY
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State | NY
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Zip | 11771-3705
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Country | US
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Telephone | 516-802-5676
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Fax |
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Authorized Official
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Title or Position | CO-OWNER
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Name | JOHN M CASTRONOVA
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Credential | PSYD
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Telephone | 516-802-5676
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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