Provider Demographics
NPI:1417151887
Name:GIAMBALVO, EDWARD THOMAS (ABOC, FNAO)
Entity Type:Individual
Prefix:MR
First Name:EDWARD
Middle Name:THOMAS
Last Name:GIAMBALVO
Suffix:
Gender:M
Credentials:ABOC, FNAO
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:819 YONKERS AVE
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10704-3052
Mailing Address - Country:US
Mailing Address - Phone:914-375-5775
Mailing Address - Fax:914-476-5021
Practice Address - Street 1:819 YONKERS AVE
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10704-3052
Practice Address - Country:US
Practice Address - Phone:914-375-5775
Practice Address - Fax:914-476-5021
Is Sole Proprietor?:No
Enumeration Date:2007-06-12
Last Update Date:2009-09-01
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician