Provider Demographics
NPI:1053148940
Name:GIANNELLI, CRISTINA A
Entity type:Individual
Prefix:
First Name:CRISTINA
Middle Name:A
Last Name:GIANNELLI
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 1:8933 98TH ST
Mailing Address - Street 2:
Mailing Address - City:WOODHAVEN
Mailing Address - State:NY
Mailing Address - Zip Code:11421-2731
Mailing Address - Country:US
Mailing Address - Phone:347-957-9842
Mailing Address - Fax:
Practice Address - Street 1:122 W 26TH ST RM 704
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-6983
Practice Address - Country:US
Practice Address - Phone:646-801-8565
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-16
Last Update Date:2024-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY052690-01208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation