Most Relevant Information
Provider Data
| NPI Number: | 1003587353 |
| Provider Name: | ANDY MARTYN CASANOVA |
| Entity Type: | Individual |
| Taxonomy Code: | 101Y00000X |
| Specialty: | Counselor |
| License Number: |
Most Important Dates
| Enumeration Date: | 09/27/2021 |
| Last Updated: | 09/27/2021 |
Provider Practice Location
1090 AMSTERDAM AVE FL 15
NEW YORK
NY
100251737
Practice Location Phone/Fax
| Phone: | 2126361474 |
| Fax: |
Provider Mailing Location
1090 AMSTERDAM AVE FL 15
NEW YORK
NY
100251737
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |