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NPI Code Detail

MEDICARE: BERNARDUS JOHANNES DE ROOIJ

MEDICARE: BERNARDUS JOHANNES DE ROOIJ
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number : 1164378857
Entity Type Code : Individual
Provider Name (Legal Business Name) : BERNARDUS JOHANNES DE ROOIJ
Provider Business Mailing Address
First Line : 329 N SALINA ST
Second Line :
City : SYRACUSE
State : NY
Zip : 13203-1755
Country : US
Telephone Number : 315-471-1564
Fax Number :
Provider Business Practice Location Address
First Line : 329 N SALINA ST
Second Line :
City : SYRACUSE
State : NY
Zip : 13203-1755
Country : US
Telephone Number : 315-471-1564
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/06/2026
Last Update Date : 03/06/2026

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Directions to “ BERNARDUS JOHANNES DE ROOIJ ” Practice Location

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