Basic Information
| Provider Information | |||||||||
| NPI: | 1003013905 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DEPALMA-BRANDT | ||||||||
| FirstName: | ANTONIA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | LCSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10420 QUEENS BLVD | ||||||||
| Address2: | 20Y | ||||||||
| City: | FOREST HILLS | ||||||||
| State: | NY | ||||||||
| PostalCode: | 113753629 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7186068587 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 156 5TH AVE | ||||||||
| Address2: | SUITE 508 | ||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100107002 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2127144539 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/03/2007 | ||||||||
| LastUpdateDate: | 04/13/2010 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | 073105 | NY | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.