Provider Demographics
NPI:1255757589
Name:GIACOMAZZI, OLIVIA
Entity type:Individual
Prefix:MS
First Name:OLIVIA
Middle Name:
Last Name:GIACOMAZZI
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 1:80 CHAMBERS ST
Mailing Address - Street 2:SUITE 8D
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10007-1839
Mailing Address - Country:US
Mailing Address - Phone:773-343-3484
Mailing Address - Fax:
Practice Address - Street 1:80 CHAMBERS ST
Practice Address - Street 2:SUITE 8D
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10007-1839
Practice Address - Country:US
Practice Address - Phone:773-343-3484
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-11
Last Update Date:2014-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool