1346521143 NPI number — CAROLYN GIAMBUSSO-YI L.C.S.W.

NPI Number: 1346521143
Health Care Provider/Practitioner: CAROLYN GIAMBUSSO-YI L.C.S.W.

NPI Number : 1346521143 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1346521143",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "GIAMBUSSO-YI",
    "FirstName": "CAROLYN",
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "L.C.S.W.",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "GIAMBUSSO",
    "OtherFirstName": "CAROLYN",
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "121 NEWARK AVE STE 503",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "JERSEY CITY",
    "MailingAddressStateName": "NJ",
    "MailingAddressPostalCode": "07302-5873",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "201-240-6186",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "121 NEWARK AVE STE 503",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "JERSEY CITY",
    "PracticeLocationAddressStateName": "NJ",
    "PracticeLocationAddressPostalCode": "07302-5873",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "201-240-6186",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "09/07/2011",
    "LastUpdateDate": "10/24/2019",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "1041C0700X",
        "TaxonomyName": "Clinical Social Worker",
        "LicenseNumber": "44SC05567000",
        "LicenseNumberStateCode": "NJ",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}