Provider Demographics
NPI:1518099985
Name:PALISI, ANTHONY T (EDD)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:T
Last Name:PALISI
Suffix:
Gender:M
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:810 RIVERVIEW DR
Mailing Address - Street 2:
Mailing Address - City:BRIELLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08730-1718
Mailing Address - Country:US
Mailing Address - Phone:732-223-5379
Mailing Address - Fax:
Practice Address - Street 1:810 RIVERVIEW DR
Practice Address - Street 2:
Practice Address - City:BRIELLE
Practice Address - State:NJ
Practice Address - Zip Code:08730-1718
Practice Address - Country:US
Practice Address - Phone:732-223-5379
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ1233103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist