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NPI Code Detail

MEDICARE: GRISSEL NAVEDO CASAC

MEDICARE: GRISSEL NAVEDO CASAC
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) Counselor16665NY

General Provider Information

NPI Number : 1619621570
Entity Type Code : Individual
Provider Name (Legal Business Name) : GRISSEL NAVEDO CASAC
Provider Business Mailing Address
First Line : 311 E 175TH ST
Second Line :
City : BRONX
State : NY
Zip : 10457-5848
Country : US
Telephone Number : 718-299-1100
Fax Number :
Provider Business Practice Location Address
First Line : 1776 CLAY AVE
Second Line :
City : BRONX
State : NY
Zip : 10457-7299
Country : US
Telephone Number : 718-960-7599
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/09/2022
Last Update Date : 02/09/2022

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Directions to “ GRISSEL NAVEDO CASAC” Practice Location

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