Healthcare Provider Details

I. General information

NPI: 1558302729
Provider Name (Legal Business Name): GERALDINE ANN GERMANO-YAW NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2006
Last Update Date: 04/05/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 EAST GREEN ST
ITHACA NY
14850
US

IV. Provider business mailing address

6131 BIG HILL RD
MORAVIA NY
13118
US

V. Phone/Fax

Practice location:
  • Phone: 607-274-6230
  • Fax: 607-274-6316
Mailing address:
  • Phone: 607-274-6230
  • Fax: 607-274-6316

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberF3311701
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberF4010451
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number3797211
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: