Provider Demographics
NPI:1598098337
Name:SHORE PIZZUTIELLO, ALISSA J (LCSW)
Entity type:Individual
Prefix:MRS
First Name:ALISSA
Middle Name:J
Last Name:SHORE PIZZUTIELLO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:58-20 LITTLE NECK PKWY
Mailing Address - Street 2:LITTLE NECK SAMUEL FIELD YM-YWHA
Mailing Address - City:N.Y.
Mailing Address - State:NY
Mailing Address - Zip Code:11362
Mailing Address - Country:US
Mailing Address - Phone:718-225-6750
Mailing Address - Fax:
Practice Address - Street 1:58-20 LITTLE NECK PKWY
Practice Address - Street 2:LITTLE NECK SAMUEL FIELD YM-YWHA
Practice Address - City:N.Y.
Practice Address - State:NY
Practice Address - Zip Code:11362
Practice Address - Country:US
Practice Address - Phone:718-225-6750
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-11
Last Update Date:2009-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR075017-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical