Provider Demographics
NPI:1427497924
Name:CIURLEO-WALZ, ANNA M
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:M
Last Name:CIURLEO-WALZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ANNA
Other - Middle Name:MARIA
Other - Last Name:CIURLEO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSED
Mailing Address - Street 1:75-30 61ST STREET
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11385
Mailing Address - Country:US
Mailing Address - Phone:917-951-5562
Mailing Address - Fax:
Practice Address - Street 1:7530 61ST ST
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:NY
Practice Address - Zip Code:11385-6124
Practice Address - Country:US
Practice Address - Phone:917-951-5562
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-18
Last Update Date:2013-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist