Jorge Luis Acevedo

Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Buffalo, NY

NPI 1518719087 · NPPES record last updated Apr 19, 2024

Key facts

NPI
1518719087
Entity type
Individual (NPI type 1)
Primary specialty
Addiction (Substance Use Disorder) Counselor 101YA0400X
License
33728 (NY)
Practice address
430 Niagara St
Buffalo, NY 14201-1886
Phone
(716) 853-1335
Fax
(716) 853-1598
NPI assigned
Apr 5, 2024
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
33728NYMDAddiction (Substance Use Disorder) Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 33728 NY Yes

Addresses

Primary practice location

430 Niagara St
Buffalo, NY 14201-1886

Mailing address

430 Niagara St
Buffalo, NY 14201-1886
Phone (716) 853-1335

Other providers in Buffalo, NY

All providers in Buffalo, NY · Addiction (Substance Use Disorder) Counselor in New York

Sources for this page

Verify at the official NPI Registry.