Individual
THERESA GIANNATTASIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
203 HILLSIDE AVE, LIVINGSTON, NJ 07039-3648
(973) 992-5588
Mailing address
PO BOX 416457, BOSTON, MA 02241-6457
(844) 362-1735
(973) 290-7495
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
25MB09286900
NJ
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/10/2012
Last updated
07/02/2019
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