| Iaso Innovative Recovery Corporation | |
|
14 Seneca St East Northport NY 11731-1039 | |
| (631) 897-6493 | |
| Not Available |
| Full Name | Iaso Innovative Recovery Corporation |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 14 Seneca St, East Northport, New York |
| Authorized Official Name and Position | Laura Colantuono (PRESIDENT) |
| Authorized Official Contact | 6318976493 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Iaso Innovative Recovery Corporation 14 Seneca St East Northport NY 11731-1039 Ph: (631) 897-6493 | Iaso Innovative Recovery Corporation 14 Seneca St East Northport NY 11731-1039 Ph: (631) 897-6493 |
| NPI Number | 1831969161 |
|---|---|
| Provider Enumeration Date | 01/08/2024 |
| Last Update Date | 01/08/2024 |
| Certification Date | 01/08/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831969161 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
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