Provider Demographics
NPI:1871711366
Name:GIUNTA, ANITA DIANE (PHD)
Entity type:Individual
Prefix:DR
First Name:ANITA
Middle Name:DIANE
Last Name:GIUNTA
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:374 ISLIP AVE
Mailing Address - Street 2:SUITE 205
Mailing Address - City:ISLIP
Mailing Address - State:NY
Mailing Address - Zip Code:11751-1807
Mailing Address - Country:US
Mailing Address - Phone:631-859-0475
Mailing Address - Fax:631-289-8840
Practice Address - Street 1:374 ISLIP AVE
Practice Address - Street 2:SUITE 205
Practice Address - City:ISLIP
Practice Address - State:NY
Practice Address - Zip Code:11751-1807
Practice Address - Country:US
Practice Address - Phone:631-859-0475
Practice Address - Fax:631-289-8840
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-23
Last Update Date:2022-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009151103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01040257Medicaid