Provider Demographics
NPI:1598961880
Name:HUTCHINSON, ERIC LESLIE (CASAC)
Entity Type:Individual
Prefix:MR
First Name:ERIC
Middle Name:LESLIE
Last Name:HUTCHINSON
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 1:17919 SELOVER RD
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11434-3409
Mailing Address - Country:US
Mailing Address - Phone:718-978-1951
Mailing Address - Fax:
Practice Address - Street 1:17919 SELOVER RD
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11434-3409
Practice Address - Country:US
Practice Address - Phone:718-978-1951
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYCASAC-20049101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY20049OtherCASAC