Provider Demographics
NPI:1730064494
Name:SAEVA, BRYAN VINCENT (CASAC)
Entity type:Individual
Prefix:
First Name:BRYAN
Middle Name:VINCENT
Last Name:SAEVA
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 1:518 JAMES ST
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13203-2238
Mailing Address - Country:US
Mailing Address - Phone:585-935-1626
Mailing Address - Fax:585-935-1626
Practice Address - Street 1:610 N STATE ST
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13203-1709
Practice Address - Country:US
Practice Address - Phone:585-935-1626
Practice Address - Fax:585-935-1626
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-11
Last Update Date:2025-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY39804101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY39804Medicaid