Provider Demographics
NPI:1285999763
Name:GIANNASCO PIZZA, MARIANNE
Entity type:Individual
Prefix:MRS
First Name:MARIANNE
Middle Name:
Last Name:GIANNASCO PIZZA
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:MARIANNE
Other - Middle Name:
Other - Last Name:GIANNASCO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:100 N PARK AVE
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE CENTRE
Mailing Address - State:NY
Mailing Address - Zip Code:11570-4157
Mailing Address - Country:US
Mailing Address - Phone:516-678-0707
Mailing Address - Fax:516-678-5990
Practice Address - Street 1:100 N PARK AVE
Practice Address - Street 2:
Practice Address - City:ROCKVILLE CENTRE
Practice Address - State:NY
Practice Address - Zip Code:11570-4157
Practice Address - Country:US
Practice Address - Phone:516-678-0707
Practice Address - Fax:516-678-5990
Is Sole Proprietor?:No
Enumeration Date:2012-07-10
Last Update Date:2012-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator