Provider Demographics
NPI:1932880416
Name:DEBIANCHI, VICTOR PAUL III
Entity Type:Individual
Prefix:
First Name:VICTOR
Middle Name:PAUL
Last Name:DEBIANCHI
Suffix:III
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11050 71ST RD STE 1M
Mailing Address - Street 2:
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-4972
Mailing Address - Country:US
Mailing Address - Phone:929-900-6956
Mailing Address - Fax:
Practice Address - Street 1:11050 71ST RD STE 1M
Practice Address - Street 2:
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-4972
Practice Address - Country:US
Practice Address - Phone:929-900-6956
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-27
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical