1992882294 NPI number — LORIANN ZAVAGLIA LCSW

Table of content: LORIANN ZAVAGLIA LCSW (NPI 1992882294)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1992882294 NPI number — LORIANN ZAVAGLIA LCSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ZAVAGLIA
Provider First Name:
LORIANN
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LCSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1992882294
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:
9935 SHORE RD
Provider Second Line Business Mailing Address:
APT 1C
Provider Business Mailing Address City Name:
BROOKLYN
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11209-7934
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
718-837-1796
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2795 RICHMOND AVE
Provider Second Line Business Practice Location Address:
2ND FLOOR
Provider Business Practice Location Address City Name:
STATEN ISLAND
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10314-5857
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-761-9800
Provider Business Practice Location Address Fax Number:
718-370-1142
Provider Enumeration Date:
11/01/2006

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: 1041C0700X , with the licence number:  071048-1 , 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)

  • Identifier: W22701 . This is a "B/C B/S" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 065452-A37 . This is a "HEALTHFIRST" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 00071048 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".




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