Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN1001X | Nutrition | X002784 | NY |
NPI | 1043306137 |
---|---|
Provider Name | Dr. Christine Gizoni |
First Address | Sayville, NY 11782-2708 |
Second Address | Sayville, NY 11782-2708 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/10/2006 |
Last Update Date | 28/08/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
CO-2784-3 | WORKMANS COMPENSATION (01) | NY |