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General NPI Number Information
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NPI Number | 1902749740
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Entity Type | Individual
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Provider Name | MARIANNA CHRYSILIOU CASAC2
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Gender | Female
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Dates
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Enumeration Date | 04/14/2026
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Last Update Date | 04/14/2026
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Provider Practice Location Address
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Address Line | 25 CHAPEL ST FL 7
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City | BROOKLYN
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State | NY
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Zip | 11201-1954
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Country | US
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Telephone | 718-858-9658
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Fax | 718-858-9670
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Provider Business Mailing Address
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Address Line | 4509 25TH AVE APT 2
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City | ASTORIA
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State | NY
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Zip | 11103-1015
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Country | US
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Telephone | 718-858-9658
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Fax | 718-858-9670
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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 | 42115
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License Number State | NY
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