Provider Demographics
NPI:1730859810
Name:GIANNOTTI, MARY FRANCES (PMHNP-BC)
Entity type:Individual
Prefix:MS
First Name:MARY FRANCES
Middle Name:
Last Name:GIANNOTTI
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 PERKINS ST
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06513-3209
Mailing Address - Country:US
Mailing Address - Phone:203-907-5979
Mailing Address - Fax:
Practice Address - Street 1:54 E RAMSDELL ST
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06515-1140
Practice Address - Country:US
Practice Address - Phone:203-337-9943
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-20
Last Update Date:2022-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT10039363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT008022622Medicaid
CT004082260Medicaid
CT008001325Medicaid
CT008039745Medicaid
CT008023170Medicaid
CT008042339Medicaid
CT008105797Medicaid
CT008024427Medicaid