Healthcare Provider Details

I. General information

NPI: 1588020671
Provider Name (Legal Business Name): ANNA PALUMBO MA, LCAT, MT-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/06/2016
Last Update Date: 01/06/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

273 WILLOUGHBY AVE
BROOKLYN NY
11205-1418
US

IV. Provider business mailing address

483 GRANDVIEW AVE APT. 1
RIDGEWOOD NY
11385-1954
US

V. Phone/Fax

Practice location:
  • Phone: 718-832-1075
  • Fax:
Mailing address:
  • Phone: 757-871-8936
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225A00000X
TaxonomyMusic Therapist
License Number001778-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: