Provider Demographics
NPI:1154630234
Name:GIAN, MARC JAY (L AC, LMT)
Entity Type:Individual
Prefix:MR
First Name:MARC
Middle Name:JAY
Last Name:GIAN
Suffix:
Gender:M
Credentials:L AC, LMT
Other - Prefix:
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Mailing Address - Street 1:928 BROADWAY
Mailing Address - Street 2:1200
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10010-6008
Mailing Address - Country:US
Mailing Address - Phone:845-519-9256
Mailing Address - Fax:212-993-6097
Practice Address - Street 1:928 BROADWAY
Practice Address - Street 2:1200
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-6008
Practice Address - Country:US
Practice Address - Phone:845-519-9256
Practice Address - Fax:212-993-6097
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-06
Last Update Date:2010-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002530171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist