Provider Demographics
NPI:1700355658
Name:AVANZA PRACTICE PARTNERS
Entity Type:Organization
Organization Name:AVANZA PRACTICE PARTNERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:NUNZIO
Authorized Official - Middle Name:
Authorized Official - Last Name:SIGNORELLA
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW, CASAC
Authorized Official - Phone:347-675-9873
Mailing Address - Street 1:300 W 72ND ST APT 1C
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023-2661
Mailing Address - Country:US
Mailing Address - Phone:347-675-9873
Mailing Address - Fax:585-539-1021
Practice Address - Street 1:300 W 72ND ST APT 1C
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-2661
Practice Address - Country:US
Practice Address - Phone:347-675-9873
Practice Address - Fax:585-539-1021
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-21
Last Update Date:2019-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty