Doctor Name: | WAYNE J CAVALIERE |
NPI Number: | 1124149430 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | 1442 |
Business Practice Address: | 31 E Montauk Hwy Hampton Bays, NY - 119461816 |
Business Phone Number: | 6317233362 |
Business Fax Number: | |
Mailing Address: | 64 Bay Ave, HAMPTON BAYS |
State: | NY |
Postal Code: | 119462514 |
Phone Number: | 6317233362 |
Fax Number: | |
NPI Enumeration Date: | 04/03/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | 1442 |
Healthcare Provider Taxonomy: (Secondary) | X |
State: | NY |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |