Doctor Name: | MR. VICTURE G RICE |
NPI Number: | 1023184462 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | CASAC |
License Number: | 019523 |
Business Practice Address: | 80th St & 41st Ave Elmhurst, NY - 113731329 |
Business Phone Number: | 7183343900 |
Business Fax Number: | 7183343432 |
Mailing Address: | 7901 Broadway, Managed Care, D1-01 ELMHURST |
State: | NY |
Postal Code: | 113731329 |
Phone Number: | 7183341921 |
Fax Number: | 7183343432 |
NPI Enumeration Date: | 11/28/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | 019523 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |