Provider Demographics
NPI:1831450725
Name:GIAMUNDO, VICKI
Entity type:Individual
Prefix:MRS
First Name:VICKI
Middle Name:
Last Name:GIAMUNDO
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 1:3 GREENHILLS RD
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON STATION
Mailing Address - State:NY
Mailing Address - Zip Code:11746-3905
Mailing Address - Country:US
Mailing Address - Phone:516-669-2205
Mailing Address - Fax:516-277-1486
Practice Address - Street 1:3 GREENHILLS RD
Practice Address - Street 2:
Practice Address - City:HUNTINGTON STATION
Practice Address - State:NY
Practice Address - Zip Code:11746-3905
Practice Address - Country:US
Practice Address - Phone:516-669-2205
Practice Address - Fax:516-277-1486
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-06
Last Update Date:2013-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator