Provider Demographics
NPI:1417176918
Name:POINSETTE, ATIF B (CASAC)
Entity Type:Individual
Prefix:
First Name:ATIF
Middle Name:B
Last Name:POINSETTE
Suffix:
Gender:M
Credentials:CASAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 EDISON AVE
Mailing Address - Street 2:3
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12208-2436
Mailing Address - Country:US
Mailing Address - Phone:518-434-6135
Mailing Address - Fax:
Practice Address - Street 1:2925 HAMBURG ST
Practice Address - Street 2:
Practice Address - City:SCHENECTADY
Practice Address - State:NY
Practice Address - Zip Code:12303-4343
Practice Address - Country:US
Practice Address - Phone:218-373-2909
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY13056101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)