Healthcare Provider Details

I. General information

NPI: 1770860488
Provider Name (Legal Business Name): GIOVANNA SINANIAN PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/08/2011
Last Update Date: 02/27/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

584 FOREST AVE
STATEN ISLAND NY
10310-2512
US

IV. Provider business mailing address

584 FOREST AVE
STATEN ISLAND NY
10310-2512
US

V. Phone/Fax

Practice location:
  • Phone: 917-757-5954
  • Fax:
Mailing address:
  • Phone: 917-757-5954
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number021295
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number004930
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: