Provider Demographics
NPI:1871908426
Name:GIAMBOI, JENNIFER A (MSN,RN,FNP,CLC)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:A
Last Name:GIAMBOI
Suffix:
Gender:F
Credentials:MSN,RN,FNP,CLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:467 PELTON AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10310-2127
Mailing Address - Country:US
Mailing Address - Phone:718-984-5437
Mailing Address - Fax:718-984-5488
Practice Address - Street 1:1779 RICHMOND AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10314
Practice Address - Country:US
Practice Address - Phone:718-982-6800
Practice Address - Fax:718-982-6830
Is Sole Proprietor?:No
Enumeration Date:2014-06-23
Last Update Date:2018-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF33894363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily