Healthcare Provider Details

I. General information

NPI: 1487568408
Provider Name (Legal Business Name): EMMA GIANCARLO FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2026
Last Update Date: 09/29/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 LAFAYETTE ST
NEW YORK NY
10012-2786
US

IV. Provider business mailing address

301 E 21ST ST APT 14B
NEW YORK NY
10010-6521
US

V. Phone/Fax

Practice location:
  • Phone: 820-300-4661
  • Fax:
Mailing address:
  • Phone: 201-741-0046
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number354102
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: