Provider Demographics
NPI:1760904130
Name:SAA, GIANINNA JANDY (OD)
Entity Type:Individual
Prefix:
First Name:GIANINNA
Middle Name:JANDY
Last Name:SAA
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2204 BARTOW AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10475-4616
Mailing Address - Country:US
Mailing Address - Phone:718-324-2020
Mailing Address - Fax:
Practice Address - Street 1:2204 BARTOW AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10475-4616
Practice Address - Country:US
Practice Address - Phone:718-324-2020
Practice Address - Fax:347-843-0443
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-07
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008643152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist