Provider Demographics
NPI:1417820416
Name:CARROLL, GIOVANNA JULIA
Entity type:Individual
Prefix:
First Name:GIOVANNA
Middle Name:JULIA
Last Name:CARROLL
Suffix:
Gender:X
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 N CORONA AVE APT 9
Mailing Address - Street 2:
Mailing Address - City:VALLEY STREAM
Mailing Address - State:NY
Mailing Address - Zip Code:11580-3403
Mailing Address - Country:US
Mailing Address - Phone:516-924-2733
Mailing Address - Fax:
Practice Address - Street 1:350 N CORONA AVE APT 9
Practice Address - Street 2:
Practice Address - City:VALLEY STREAM
Practice Address - State:NY
Practice Address - Zip Code:11580-3403
Practice Address - Country:US
Practice Address - Phone:516-924-2733
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-25
Last Update Date:2025-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY983318163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse