Provider Demographics
NPI:1386345163
Name:RICCIO, GIANNA MARIE
Entity type:Individual
Prefix:
First Name:GIANNA
Middle Name:MARIE
Last Name:RICCIO
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 1:580 STATE ROUTE 28 UNIT 303
Mailing Address - Street 2:
Mailing Address - City:BRIDGEWATER
Mailing Address - State:NJ
Mailing Address - Zip Code:08807-2886
Mailing Address - Country:US
Mailing Address - Phone:908-477-9807
Mailing Address - Fax:
Practice Address - Street 1:17 SPRING PL
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07960-3947
Practice Address - Country:US
Practice Address - Phone:973-539-3370
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-17
Last Update Date:2025-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS01241300235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist