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General NPI Number Information
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NPI Number | 1063174043
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Entity Type | Individual
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Provider Name | ALISSA GIAMMARINO NP
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Gender | Female
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Dates
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Enumeration Date | 10/07/2021
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Last Update Date | 10/07/2021
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Provider Practice Location Address
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Address Line | 46 HARRISON ST
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City | JOHNSON CITY
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State | NY
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Zip | 13790-2120
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Country | US
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Telephone | 607-729-4942
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Fax | 607-729-7516
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Provider Business Mailing Address
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Address Line | 33 LEWIS RD 2ND FL
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City | BINGHAMTON
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State | NY
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Zip | 13905
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Country | US
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Telephone | 607-770-0025
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Fax | 607-729-3982
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 348220
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License Number State | NY
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