MEDICARE: MISS AHYLZABETH GIANNANTONIO MSW, LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	44SC05202200	NJ

General Provider Information

NPI Number	:	1386765113
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS AHYLZABETH GIANNANTONIO MSW, LCSW

Provider Business Mailing Address
First Line	:	2201 BERGENLINE AVE
Second Line	:
City	:	UNION CITY
State	:	NJ
Zip	:	07087-3582
Country	:	US
Telephone Number	:	201-558-3726
Fax Number	:

Provider Business Practice Location Address
First Line	:	2201 BERGENLINE AVE
Second Line	:
City	:	UNION CITY
State	:	NJ
Zip	:	07087-3582
Country	:	US
Telephone Number	:	201-558-3726
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/02/2007
Last Update Date	:	08/08/2012

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