Provider Demographics
NPI:1104648351
Name:GIANNONE, MEGAN (RN)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:GIANNONE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2771 WARNERS RD
Mailing Address - Street 2:
Mailing Address - City:WARNERS
Mailing Address - State:NY
Mailing Address - Zip Code:13164-9762
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:350 WOODSPATH RD
Practice Address - Street 2:
Practice Address - City:LIVERPOOL
Practice Address - State:NY
Practice Address - Zip Code:13090-2840
Practice Address - Country:US
Practice Address - Phone:315-453-1252
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-29
Last Update Date:2024-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY645302-01163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool