1407998354 NPI number — MRS. GINA PALUMBO CANIGIANI LMSW

Table of content: MRS. GINA PALUMBO CANIGIANI LMSW (NPI 1407998354)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1407998354 NPI number — MRS. GINA PALUMBO CANIGIANI LMSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CANIGIANI
Provider First Name:
GINA
Provider Middle Name:
PALUMBO
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
LMSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
PALUMBO
Provider Other First Name:
GINA
Provider Other Middle Name:
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
LMSW
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1407998354
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
20 LEEDS ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HUNTINGTON STATION
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11746-4319
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
631-385-0187
Provider Business Mailing Address Fax Number:
631-385-0187

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
33 WALT WHITMAN RD
Provider Second Line Business Practice Location Address:
STE. 300B
Provider Business Practice Location Address City Name:
HUNTINGTON STATION
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11746-3640
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
631-682-6654
Provider Business Practice Location Address Fax Number:
631-385-0187
Provider Enumeration Date:
02/13/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 171M00000X , with the licence number:  047433-1 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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