Provider Demographics
NPI:1356402119
Name:PALLANZA, EDUARDO JORGE (LMHC)
Entity type:Individual
Prefix:MR
First Name:EDUARDO
Middle Name:JORGE
Last Name:PALLANZA
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3511 LINDEN PL
Mailing Address - Street 2:2R
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11354-2846
Mailing Address - Country:US
Mailing Address - Phone:718-661-3684
Mailing Address - Fax:
Practice Address - Street 1:3764 72ND ST
Practice Address - Street 2:QCNI
Practice Address - City:JACKSON HTS
Practice Address - State:NY
Practice Address - Zip Code:11372-6143
Practice Address - Country:US
Practice Address - Phone:718-335-3434
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health