Provider Demographics
NPI:1932246766
Name:HERNANDEZ, GIANNA R (PT)
Entity Type:Individual
Prefix:MS
First Name:GIANNA
Middle Name:R
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MS
Other - First Name:GIANNA
Other - Middle Name:
Other - Last Name:HERNANDEZ-MILETO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PT
Mailing Address - Street 1:38 HIGH ST
Mailing Address - Street 2:
Mailing Address - City:GREENWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06830-5959
Mailing Address - Country:US
Mailing Address - Phone:203-532-5536
Mailing Address - Fax:203-532-5536
Practice Address - Street 1:38 HIGH ST
Practice Address - Street 2:
Practice Address - City:GREENWICH
Practice Address - State:CT
Practice Address - Zip Code:06830-5959
Practice Address - Country:US
Practice Address - Phone:203-532-5536
Practice Address - Fax:203-532-5536
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT003993225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist