Provider Demographics
NPI:1659421568
Name:PIZZUTI, SILVANA (PHD, LAC)
Entity Type:Individual
Prefix:
First Name:SILVANA
Middle Name:
Last Name:PIZZUTI
Suffix:
Gender:F
Credentials:PHD, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 193
Mailing Address - Street 2:PLANETARIUM STATION
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-0193
Mailing Address - Country:US
Mailing Address - Phone:917-575-5932
Mailing Address - Fax:212-595-4830
Practice Address - Street 1:120 RIVERSIDE DR
Practice Address - Street 2:SUITE 2W
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-3709
Practice Address - Country:US
Practice Address - Phone:917-575-5932
Practice Address - Fax:212-595-4830
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013461103TC0700X
NY003127171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Not Answered171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY136874POtherHIP PROVIDER ID #
NYP3686655OtherOXFORD PROVIDER ID#
NYVN 3081Medicare ID - Type UnspecifiedMEDICARE PROVIDER ID #