Basic Information
| Provider Information | |||||||||
| NPI: | 1760426118 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | NUNEZ | ||||||||
| FirstName: | GIOVANNY | ||||||||
| MiddleName: | M | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | DEPT OF PSYCHIATRY, TRUSTEES OF COLUMBIA UNIVERSITY | ||||||||
| Address2: | 622 WEST 168TH STREET, BOX 260 | ||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 10032 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2123052330 | ||||||||
| FaxNumber: | 2123054724 | ||||||||
| Practice Location | |||||||||
| Address1: | ALLEN PAVILION 3 RIVER EAST | ||||||||
| Address2: | 5141 BROADWAY | ||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 10034 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2129324165 | ||||||||
| FaxNumber: | 2129325369 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/16/2006 | ||||||||
| LastUpdateDate: | 02/15/2017 | ||||||||
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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 | 2084P0800X | 205972 | NY | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry |
ID Information
| ID | Type | State | Issuer | Description | 01867587 | 05 | NY | MEDICAID |