Provider Demographics
NPI:1457841892
Name:GIANGRECO, JOHN ANGELO (FNP)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:ANGELO
Last Name:GIANGRECO
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2381 OCEAN AVE APT 1B
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-3546
Mailing Address - Country:US
Mailing Address - Phone:917-538-4717
Mailing Address - Fax:
Practice Address - Street 1:2381 OCEAN AVE APT 1B
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-3546
Practice Address - Country:US
Practice Address - Phone:917-538-4717
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-11
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY342717363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily