Provider Demographics
NPI:1275398968
Name:GIANSIRACUSA, GIULIA
Entity Type:Individual
Prefix:MISS
First Name:GIULIA
Middle Name:
Last Name:GIANSIRACUSA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 BROOKWOOD DR APT C
Mailing Address - Street 2:
Mailing Address - City:ROCKY HILL
Mailing Address - State:CT
Mailing Address - Zip Code:06067-2733
Mailing Address - Country:US
Mailing Address - Phone:860-833-0444
Mailing Address - Fax:
Practice Address - Street 1:19 BROOKWOOD DR APT C
Practice Address - Street 2:
Practice Address - City:ROCKY HILL
Practice Address - State:CT
Practice Address - Zip Code:06067-2733
Practice Address - Country:US
Practice Address - Phone:860-833-0444
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-21
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT137421041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical