Provider Demographics
NPI:1982069050
Name:MANDEL-GIAMPIETRO, ALLISON DEBORAH
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:DEBORAH
Last Name:MANDEL-GIAMPIETRO
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:ALLISON
Other - Middle Name:D
Other - Last Name:MANDEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LSW
Mailing Address - Street 1:67 6TH AVE
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:PASSAIC
Mailing Address - State:NJ
Mailing Address - Zip Code:07055-2137
Mailing Address - Country:US
Mailing Address - Phone:201-562-9490
Mailing Address - Fax:
Practice Address - Street 1:67 6TH AVE
Practice Address - Street 2:2ND FLOOR
Practice Address - City:PASSAIC
Practice Address - State:NJ
Practice Address - Zip Code:07055-2137
Practice Address - Country:US
Practice Address - Phone:201-562-9490
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-16
Last Update Date:2015-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL05541400104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker