Healthcare Provider Details

I. General information

NPI: 1770353492
Provider Name (Legal Business Name): PATRICIA MARIE GIURICEO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/03/2024
Last Update Date: 07/24/2025
Certification Date: 07/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

91 STADIUM DRIVE
CHAPEL HILL NC
27514
US

IV. Provider business mailing address

87 FALLS BRIDGE DR
TOTOWA NJ
07512-1722
US

V. Phone/Fax

Practice location:
  • Phone: 201-247-8969
  • Fax:
Mailing address:
  • Phone: 201-247-8969
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License NumberLAT-6118
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: