NPI 1083117089

Tyreek Gaston, COUNSELOR

Practitioner Substance Abuse Rehabilitation Facility Staten Island, NY

Practice location

Address: 273 Heberton Ave, Staten Island, NY 10302-1809
Phone: (718) 412-3170

Registered specialties

Substance Abuse Rehabilitation Facility Primary

Residential Treatment Facilities Taxonomy 324500000X

Other Substance Abuse Rehabilitation Facility providers in New York →

Registry record

NPI: 1083117089
Entity type: Individual
Sex (as registered): Male
NPI issued: 15 Mar 2018
Record last updated: 15 Mar 2018

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.