Provider Demographics
NPI:1831269968
Name:ASTORE, ANN BARRY (CASAC)
Entity type:Individual
Prefix:MRS
First Name:ANN
Middle Name:BARRY
Last Name:ASTORE
Suffix:
Gender:F
Credentials:CASAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:126 N FRANKLIN ST
Mailing Address - Street 2:
Mailing Address - City:HEMPSTEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11550-1318
Mailing Address - Country:US
Mailing Address - Phone:516-486-7200
Mailing Address - Fax:516-486-7291
Practice Address - Street 1:126 N FRANKLIN ST
Practice Address - Street 2:
Practice Address - City:HEMPSTEAD
Practice Address - State:NY
Practice Address - Zip Code:11550-1318
Practice Address - Country:US
Practice Address - Phone:516-486-7200
Practice Address - Fax:516-486-7291
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY11336101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)