1053392159 NPI number — JANE ELIZABETH GIARRIZZO LCSW-R, ACSW, OSW-C

Table of content: JANE ELIZABETH GIARRIZZO LCSW-R, ACSW, OSW-C (NPI 1053392159)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1053392159 NPI number — JANE ELIZABETH GIARRIZZO LCSW-R, ACSW, OSW-C

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GIARRIZZO
Provider First Name:
JANE
Provider Middle Name:
ELIZABETH
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LCSW-R, ACSW, OSW-C
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1053392159
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9 BURWELL DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MACEDON
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
14502-8945
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
585-727-2776
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
21 WILLOW POND WAY
Provider Second Line Business Practice Location Address:
SUITE 202
Provider Business Practice Location Address City Name:
PENFIELD
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
14526-2687
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
585-727-2776
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/07/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  R039836-1 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: PO10039836 . This is a "MONROE PLAN" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: PO10039836 . This is a "BLUE CHOIC" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: RC80039836 . This is a "RCIPA" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 02544223 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 512230 . This is a "VALUE OPTIONS" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: PO10039836 . This is a "EXCELLUS" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 133004FK . This is a "PREFERRED CARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 7004570 . This is a "AETNA" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: PO10039836 . This is a "VIAHEALTH" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




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