Provider Demographics
NPI:1184407728
Name:TRAVAGLIONE, ALLAN (MS, MED)
Entity type:Individual
Prefix:MR
First Name:ALLAN
Middle Name:
Last Name:TRAVAGLIONE
Suffix:
Gender:M
Credentials:MS, MED
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 2960
Mailing Address - Street 2:
Mailing Address - City:NANTUCKET
Mailing Address - State:MA
Mailing Address - Zip Code:02584-2960
Mailing Address - Country:US
Mailing Address - Phone:508-332-9363
Mailing Address - Fax:
Practice Address - Street 1:10 SURFSIDE RD
Practice Address - Street 2:
Practice Address - City:NANTUCKET
Practice Address - State:MA
Practice Address - Zip Code:02554-6052
Practice Address - Country:US
Practice Address - Phone:508-332-9363
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-16
Last Update Date:2024-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor