Provider Demographics
NPI:1184684094
Name:GIANNONE, VINCENT R (PSYD)
Entity Type:Individual
Prefix:DR
First Name:VINCENT
Middle Name:R
Last Name:GIANNONE
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:52 S MANHEIM BLVD
Mailing Address - Street 2:
Mailing Address - City:NEW PALTZ
Mailing Address - State:NY
Mailing Address - Zip Code:12561-2406
Mailing Address - Country:US
Mailing Address - Phone:845-242-3503
Mailing Address - Fax:845-255-0034
Practice Address - Street 1:52 S MANHEIM BLVD
Practice Address - Street 2:
Practice Address - City:NEW PALTZ
Practice Address - State:NY
Practice Address - Zip Code:12561-2406
Practice Address - Country:US
Practice Address - Phone:845-242-3503
Practice Address - Fax:845-255-0034
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009338103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYVM2012Medicare ID - Type Unspecified