Provider Demographics
NPI:1629647235
Name:GENTILE, GIANNA
Entity Type:Individual
Prefix:
First Name:GIANNA
Middle Name:
Last Name:GENTILE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44 OTTAVIO PROMENADE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10307-2411
Mailing Address - Country:US
Mailing Address - Phone:347-463-0137
Mailing Address - Fax:
Practice Address - Street 1:44 OTTAVIO PROMENADE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10307-2411
Practice Address - Country:US
Practice Address - Phone:347-463-0137
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-18
Last Update Date:2021-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist