Basic Information
| Provider Information | |||||||||
| NPI: | 1275723447 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GIAMBELLUCA | ||||||||
| FirstName: | TRICIA | ||||||||
| MiddleName: | RYNSKI | ||||||||
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| Credential: | MHC | ||||||||
| OtherOrganizationName: | |||||||||
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| OtherLastName: | RYNSKI | ||||||||
| OtherFirstName: | TRICIA | ||||||||
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| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 227 THORN AVE | ||||||||
| Address2: | BOX 631 | ||||||||
| City: | ORCHARD PARK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 141272600 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7166622040 | ||||||||
| FaxNumber: | 7166620019 | ||||||||
| Practice Location | |||||||||
| Address1: | 2040 SENECA ST | ||||||||
| Address2: | |||||||||
| City: | BUFFALO | ||||||||
| State: | NY | ||||||||
| PostalCode: | 142102324 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7168280560 | ||||||||
| FaxNumber: | 7168281522 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/25/2007 | ||||||||
| LastUpdateDate: | 02/24/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | 004699 | NY | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.