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General NPI Number Information
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NPI Number | 1952841397
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Entity Type | Individual
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Provider Name | JUAN CARLOS DIAZ CASAC
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Gender | Male
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Dates
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Enumeration Date | 03/05/2017
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Last Update Date | 03/05/2017
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Provider Practice Location Address
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Address Line | 33 GUY LOMBARDO AVE H.E.L.P. SERVICES
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City | FREEPORT
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State | NY
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Zip | 11520-3637
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Country | US
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Telephone | 516-546-2822
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Fax | 516-546-5051
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Provider Business Mailing Address
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Address Line | 368 BEECH ST
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City | SOUTH HEMPSTEAD
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State | NY
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Zip | 11550-7746
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Country | US
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Telephone | 516-902-4629
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Fax | 718-264-4188
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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 | 24671
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License Number State | NY
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