Healthcare Provider Details

I. General information

NPI: 1659202588
Provider Name (Legal Business Name): LUANNA PALAZZOLO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/28/2026
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 MOUNTAINVIEW BLVD STE 207
BASKING RIDGE NJ
07920-3453
US

IV. Provider business mailing address

25 MOUNTAINVIEW BLVD STE 207
BASKING RIDGE NJ
07920-3453
US

V. Phone/Fax

Practice location:
  • Phone: 908-948-0688
  • Fax:
Mailing address:
  • Phone: 908-948-0688
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number18KT00431000
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: