Healthcare Provider Details

I. General information

NPI: 1871908426
Provider Name (Legal Business Name): JENNIFER A GIAMBOI MSN,RN,FNP,CLC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2014
Last Update Date: 05/31/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1779 RICHMOND AVE
STATEN ISLAND NY
10314
US

IV. Provider business mailing address

467 PELTON AVE
STATEN ISLAND NY
10310-2127
US

V. Phone/Fax

Practice location:
  • Phone: 718-982-6800
  • Fax: 718-982-6830
Mailing address:
  • Phone: 718-984-5437
  • Fax: 718-984-5488

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF33894
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: