Provider Demographics
NPI:1487075313
Name:GIANCOLA, KRISTYNA HNIZDA (PA)
Entity type:Individual
Prefix:
First Name:KRISTYNA
Middle Name:HNIZDA
Last Name:GIANCOLA
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5898 BRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:EAST SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13057-2941
Mailing Address - Country:US
Mailing Address - Phone:315-663-0112
Mailing Address - Fax:
Practice Address - Street 1:5898 BRIDGE ST
Practice Address - Street 2:
Practice Address - City:EAST SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13057-2941
Practice Address - Country:US
Practice Address - Phone:315-663-0112
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-12-19
Last Update Date:2015-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant