| Doctor Name: | DR. ALLEN PAUL BLASUCCI |
| NPI Number: | 1134337405 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PSY.D. |
| License Number: | 35SI00125400 |
| Business Practice Address: | 43 Tamarack Cir Skillman, NJ - 085582019 |
| Business Phone Number: | 6099248010 |
| Business Fax Number: | 6096880045 |
| Mailing Address: | 380 Mountain Rd, Apt 1212 UNION CITY |
| State: | NJ |
| Postal Code: | 070877340 |
| Phone Number: | 2019668737 |
| Fax Number: | |
| NPI Enumeration Date: | 05/19/2007 |
| NPI Last Update Date: | 07/25/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | 35SI00125400 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NJ |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |