Provider Demographics
NPI:1306185590
Name:GIUNTA, GIANCARLO VINCENT
Entity Type:Individual
Prefix:MR
First Name:GIANCARLO
Middle Name:VINCENT
Last Name:GIUNTA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8217 153RD AVE
Mailing Address - Street 2:200
Mailing Address - City:HOWARD BEACH
Mailing Address - State:NY
Mailing Address - Zip Code:11414-1791
Mailing Address - Country:US
Mailing Address - Phone:718-487-3100
Mailing Address - Fax:718-487-3126
Practice Address - Street 1:8217 153RD AVE
Practice Address - Street 2:200
Practice Address - City:HOWARD BEACH
Practice Address - State:NY
Practice Address - Zip Code:11414-1791
Practice Address - Country:US
Practice Address - Phone:718-487-3100
Practice Address - Fax:718-487-3126
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-07
Last Update Date:2013-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017844225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist