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NPI Code Detail

MEDICARE: MS. CHERYL L. NAZARIO C.A.S.A.C.

MEDICARE: MS. CHERYL L. NAZARIO C.A.S.A.C.
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) Counselor10489NY

General Provider Information

NPI Number : 1518125228
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. CHERYL L. NAZARIO C.A.S.A.C.
Provider Business Mailing Address
First Line : PO BOX 20242
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10302-0242
Country : US
Telephone Number : 347-451-9430
Fax Number :
Provider Business Practice Location Address
First Line : 1915 FOREST AVE
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10303-2127
Country : US
Telephone Number : 718-981-3270
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/29/2008
Last Update Date : 05/29/2008

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