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General NPI Number Information
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NPI Number | 1861355521
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Entity Type | Individual
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Provider Name | MR. MICHAEL R GIANNONE I
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Gender | Male
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Dates
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Enumeration Date | 12/08/2025
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Last Update Date | 12/08/2025
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Provider Practice Location Address
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Address Line | 8 WALL ST APT 104
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City | CLIFTON PARK
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State | NY
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Zip | 12065-3886
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Country | US
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Telephone | 518-505-4650
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2128
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City | MALTA
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State | NY
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Zip | 12020-8128
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Country | US
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Telephone | 518-505-4650
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Fax |
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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 | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State | NY
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