Provider Demographics
NPI:1093493066
Name:GIACALONE, GINA ANN (NP)
Entity Type:Individual
Prefix:
First Name:GINA
Middle Name:ANN
Last Name:GIACALONE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 CALIFORNIA RD APT 24
Mailing Address - Street 2:
Mailing Address - City:BRONXVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:10708-4427
Mailing Address - Country:US
Mailing Address - Phone:914-806-3657
Mailing Address - Fax:
Practice Address - Street 1:200 CALIFORNIA RD APT 24
Practice Address - Street 2:
Practice Address - City:BRONXVILLE
Practice Address - State:NY
Practice Address - Zip Code:10708-4427
Practice Address - Country:US
Practice Address - Phone:914-806-3657
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-10
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF351437-01207Q00000X, 208000000X, 2080P0207X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0207XAllopathic & Osteopathic PhysiciansPediatricsPediatric Hematology-Oncology
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics