Provider Demographics
NPI:1407101926
Name:GIANFORCARO, MARIA L (MS ED)
Entity Type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:L
Last Name:GIANFORCARO
Suffix:
Gender:F
Credentials:MS ED
Other - Prefix:MISS
Other - First Name:MARIA
Other - Middle Name:L
Other - Last Name:BARRETTA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS ED
Mailing Address - Street 1:42-34 164TH STREET
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11358
Mailing Address - Country:US
Mailing Address - Phone:347-903-3618
Mailing Address - Fax:
Practice Address - Street 1:42-34 164TH STREET
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11358
Practice Address - Country:US
Practice Address - Phone:347-903-3618
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-20
Last Update Date:2013-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY620198121171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator