Provider Demographics
NPI:1033109525
Name:GIANGRANDE, VALERIE (OD)
Entity Type:Individual
Prefix:
First Name:VALERIE
Middle Name:
Last Name:GIANGRANDE
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 W MERRICK RD
Mailing Address - Street 2:
Mailing Address - City:FREEPORT
Mailing Address - State:NY
Mailing Address - Zip Code:11520-3826
Mailing Address - Country:US
Mailing Address - Phone:516-379-4041
Mailing Address - Fax:516-771-6794
Practice Address - Street 1:21 W MERRICK RD
Practice Address - Street 2:
Practice Address - City:FREEPORT
Practice Address - State:NY
Practice Address - Zip Code:11520-3826
Practice Address - Country:US
Practice Address - Phone:516-379-4041
Practice Address - Fax:516-771-6794
Is Sole Proprietor?:No
Enumeration Date:2005-10-25
Last Update Date:2015-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV006375152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02348745Medicaid
NYU87493Medicare UPIN
NYC175CCT321Medicare PIN
NYC175C1Medicare ID - Type Unspecified
NYA400128638Medicare PIN