Provider Demographics
NPI:1649827627
Name:GITANYU, JAMES (RN, BSN)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:GITANYU
Suffix:
Gender:M
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 GANLEY DR
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:NH
Mailing Address - Zip Code:03079-2477
Mailing Address - Country:US
Mailing Address - Phone:978-809-9388
Mailing Address - Fax:
Practice Address - Street 1:3 GANLEY DR
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:NH
Practice Address - Zip Code:03079-2477
Practice Address - Country:US
Practice Address - Phone:978-809-9388
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-23
Last Update Date:2019-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2275487163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty