Provider Demographics
NPI:1407072176
Name:GIULIANI, GEORGE ANTHONY JR (PSYD)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:ANTHONY
Last Name:GIULIANI
Suffix:JR
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 1:6 WHARTON PL
Mailing Address - Street 2:
Mailing Address - City:MELVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11747-4260
Mailing Address - Country:US
Mailing Address - Phone:631-427-6455
Mailing Address - Fax:631-427-6455
Practice Address - Street 1:6 WHARTON PL
Practice Address - Street 2:
Practice Address - City:MELVILLE
Practice Address - State:NY
Practice Address - Zip Code:11747-4260
Practice Address - Country:US
Practice Address - Phone:631-427-6455
Practice Address - Fax:631-427-6455
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-18
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013538103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01924996Medicaid
NY01924996Medicaid