Provider Demographics
NPI:1508241274
Name:VAYSPITER, DOREAN (CASAC-T)
Entity Type:Individual
Prefix:MR
First Name:DOREAN
Middle Name:
Last Name:VAYSPITER
Suffix:
Gender:M
Credentials:CASAC-T
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:408 77TH ST BSMT 2
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11209-3249
Mailing Address - Country:US
Mailing Address - Phone:718-833-3320
Mailing Address - Fax:718-833-2422
Practice Address - Street 1:408 77TH ST BSMT 2
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11209-3249
Practice Address - Country:US
Practice Address - Phone:718-833-3320
Practice Address - Fax:718-833-2422
Is Sole Proprietor?:No
Enumeration Date:2015-07-23
Last Update Date:2015-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY29272101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)