Provider Demographics
NPI:1093959546
Name:GIUSTI, IRENE (PHD)
Entity Type:Individual
Prefix:DR
First Name:IRENE
Middle Name:
Last Name:GIUSTI
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2615 9TH ST
Mailing Address - Street 2:
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11102-3934
Mailing Address - Country:US
Mailing Address - Phone:718-204-0233
Mailing Address - Fax:718-204-0234
Practice Address - Street 1:16-15 9 STREET
Practice Address - Street 2:PRIVATE HOUSE
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11102
Practice Address - Country:US
Practice Address - Phone:718-204-0233
Practice Address - Fax:718-204-0234
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-28
Last Update Date:2009-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012375-1103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent