Provider Demographics
NPI:1396007001
Name:MAIORANO, JENNIFER (MS ED)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:MAIORANO
Suffix:
Gender:F
Credentials:MS ED
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:
Other - Last Name:GIUCA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS ED
Mailing Address - Street 1:64 FORRESTAL AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10312-1912
Mailing Address - Country:US
Mailing Address - Phone:917-733-6211
Mailing Address - Fax:
Practice Address - Street 1:64 FORRESTAL AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10312-1912
Practice Address - Country:US
Practice Address - Phone:917-733-6211
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-10
Last Update Date:2012-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY856836174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist