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General NPI Number Information
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NPI Number | 1104451848
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Entity Type | Organization
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Legal Business Name | GIANNA OF SYRACUSE MEDICAL PLLC
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Dates
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Enumeration Date | 03/03/2020
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Last Update Date | 02/28/2025
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Provider Practice Location Address
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Address Line | 1880 E RIDGE RD STE 8
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City | ROCHESTER
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State | NY
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Zip | 14622-2450
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Country | US
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Telephone | 585-310-8787
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Fax |
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Provider Business Mailing Address
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Address Line | 1141 EAST UNION ST. #9201
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City | SYRACUSE
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State | NY
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Zip | 13219-1919
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Country | US
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Telephone | 585-310-8787
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ANGELA KRISTAN
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Credential | MD
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Telephone | 405-640-5576
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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