Provider Demographics
NPI:1588020671
Name:PALUMBO, ANNA (MA, LCAT, MT-BC)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:
Last Name:PALUMBO
Suffix:
Gender:F
Credentials:MA, LCAT, MT-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:483 GRANDVIEW AVE
Mailing Address - Street 2:APT. 1
Mailing Address - City:RIDGEWOOD
Mailing Address - State:NY
Mailing Address - Zip Code:11385-1954
Mailing Address - Country:US
Mailing Address - Phone:757-871-8936
Mailing Address - Fax:
Practice Address - Street 1:273 WILLOUGHBY AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11205-1418
Practice Address - Country:US
Practice Address - Phone:718-832-1075
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-06
Last Update Date:2016-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001778-1225A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist