Provider Demographics
NPI:1407998354
Name:CANIGIANI, GINA PALUMBO (LMSW)
Entity Type:Individual
Prefix:MRS
First Name:GINA
Middle Name:PALUMBO
Last Name:CANIGIANI
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:MRS
Other - First Name:GINA
Other - Middle Name:
Other - Last Name:PALUMBO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMSW
Mailing Address - Street 1:20 LEEDS ST
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON STATION
Mailing Address - State:NY
Mailing Address - Zip Code:11746-4319
Mailing Address - Country:US
Mailing Address - Phone:631-385-0187
Mailing Address - Fax:631-385-0187
Practice Address - Street 1:33 WALT WHITMAN RD
Practice Address - Street 2:STE. 300B
Practice Address - City:HUNTINGTON STATION
Practice Address - State:NY
Practice Address - Zip Code:11746-3640
Practice Address - Country:US
Practice Address - Phone:631-682-6654
Practice Address - Fax:631-385-0187
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY047433-1171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator