Provider Demographics
NPI:1689925059
Name:IZZI, GINA M
Entity Type:Individual
Prefix:MRS
First Name:GINA
Middle Name:M
Last Name:IZZI
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:GINA
Other - Middle Name:M
Other - Last Name:GALATIOTO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:15 TRUESDALE PL
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10705-1532
Mailing Address - Country:US
Mailing Address - Phone:914-592-8526
Mailing Address - Fax:914-592-5321
Practice Address - Street 1:5 BRADHURST AVE
Practice Address - Street 2:
Practice Address - City:HAWTHORNE
Practice Address - State:NY
Practice Address - Zip Code:10532-2135
Practice Address - Country:US
Practice Address - Phone:914-592-8526
Practice Address - Fax:914-592-5321
Is Sole Proprietor?:No
Enumeration Date:2012-09-26
Last Update Date:2012-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor