Healthcare Provider Details

I. General information

NPI: 1992882294
Provider Name (Legal Business Name): LORIANN ZAVAGLIA LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2795 RICHMOND AVE 2ND FLOOR
STATEN ISLAND NY
10314-5857
US

IV. Provider business mailing address

9935 SHORE RD APT 1C
BROOKLYN NY
11209-7934
US

V. Phone/Fax

Practice location:
  • Phone: 718-761-9800
  • Fax: 718-370-1142
Mailing address:
  • Phone: 718-837-1796
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number071048-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: