Trystan Gangi | Staten Island, NY • PECOS Search

Trystan Gangi

Social Worker

Behavioral Health & Social Service Providers

119 Tompkins Ave, Staten Island, NY 10304-2601

(347) 749-7669 (718) 887-4057

PECOS Enrollment

Based on the most recent information from CMS, provider Trystan Gangi does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records yesterday at 11:47 AM.

Profile Details

Provider ID
1790251544
Provider Type
Individual
Full Name
Gangi, Trystan
Gender
Male

Sole Proprietor
No
Enumeration Date
10/19/2018
Last Updated
10/19/2018

Contact Information

Practice Location

119 Tompkins Ave, Staten Island, NY 10304-2601

Unlisted Fax

Mailing Location

97 Richard Ln, Staten Island, NY 10314-1621

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 104100000X Primary	Description Social Worker Behavioral Health & Social Service Providers	License Unlisted Issuer New York