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General NPI Number Information
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NPI Number | 1922541556
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Entity Type | Organization
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Legal Business Name | GIANNA PHYSICIAN PRACTICE OF NEW YORK, PC
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Dates
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Enumeration Date | 11/30/2016
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Last Update Date | 11/30/2016
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Provider Practice Location Address
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Address Line | 15 E 40TH ST SUITE 101
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City | NEW YORK
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State | NY
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Zip | 10016-0401
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Country | US
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Telephone | 212-481-1219
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Fax | 212-481-1423
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Provider Business Mailing Address
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Address Line | 254 EASTON AVE
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City | NEW BRUNSWICK
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State | NJ
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Zip | 08901-1766
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Country | US
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Telephone | 732-745-8600
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Fax |
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER
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Name | MR. GARRICK STOLDT
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Credential |
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Telephone | 732-745-6651
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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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