Individual provider · Type 1 NPI

Mary Kathryn Giannico, PA

Physician Assistant · Port Jefferson, NY

NPI number 1154908390 Active

Practice location

75 N Country Rd
Port Jefferson, NY 11777-2119

Call (631) 473-1320 Map

Mailing address

134 Barrett Ave
Bayport, NY 11705-1415

Specialties and licenses

TaxonomyCodeLicense
Surgical Physician Assistant 363AS0400X026500 (NY)
Physician Assistant Primary 363A00000X026500 (NY)

Physician Assistant: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, orde…

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About NPI 1154908390

Mary Kathryn Giannico, PA's National Provider Identifier is 1154908390, issued on Mar 25, 2021. The primary taxonomy on file is Physician Assistant (363A00000X), and the practice location is in Port Jefferson, NY. The record was last updated on Jul 8, 2025.