Active NPI
Liane Giambalvo, RD, LCPC
- Registered Dietitian
- Bangor, ME
National Provider Identifier
1639197072
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- D124
- Practice address
- 905 Union St
Suite 11
Bangor, ME 04401-3050 - Phone
- (207) 973-7334
- Fax
- (207) 973-7424
- NPI assigned
- Jul 17, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | D124 | ME | Primary |
Addresses
Primary practice location
905 Union St
Suite 11
Bangor, ME 04401-3050
Mailing address
905 Union St
Suite 11
Bangor, ME 04401-3050
Phone (207) 973-7334
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D124 | ME | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Eastern Maine Medical Center | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Rehabilitation Hospital Unit
- Bangor, ME
- NPI 1780674689
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153094400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1639197072",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "905 UNION ST",
"address_2": "SUITE 11",
"city": "BANGOR",
"state": "ME",
"postal_code": "044013050",
"telephone_number": "207-973-7334",
"fax_number": "207-973-7424"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "905 UNION ST",
"address_2": "SUITE 11",
"city": "BANGOR",
"state": "ME",
"postal_code": "044013050",
"telephone_number": "207-973-7334",
"fax_number": "207-973-7424"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GIAMBALVO",
"first_name": "LIANE",
"credential": "RD, LCPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-07-17",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "ME",
"license": "D124",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bangor, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.