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General NPI Number Information
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NPI Number | 1659211381
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Entity Type | Individual
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Provider Name | NICHOLAS KANASKY CADC
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Gender | Male
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Dates
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Enumeration Date | 03/31/2026
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Last Update Date | 03/31/2026
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Provider Practice Location Address
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Address Line | 540 US HIGHWAY 22
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City | BRIDGEWATER
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State | NJ
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Zip | 08807-2405
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Country | US
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Telephone | 908-722-1881
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Fax |
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Provider Business Mailing Address
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Address Line | 54 GILBERT AVE
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City | ELMWOOD PARK
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State | NJ
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Zip | 07407-1648
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 37CA00194400
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License Number State | NJ
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