Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC2200X | Clinical Child & Adolescent Psychologist | 012375-1 | NY |
NPI | 1093959546 |
---|---|
Provider Name | Dr. Irene Giusti |
First Address | Astoria, NY 11102-3934 |
Second Address | Astoria, NY 11102 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/04/2009 |
Last Update Date | 28/04/2009 |