1518268697 NPI number — JOSEPH P. GIANCASPRO, M.D., LTD

Table of content: (NPI 1518268697)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1518268697 NPI number — JOSEPH P. GIANCASPRO, M.D., LTD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
JOSEPH P. GIANCASPRO, M.D., LTD
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1518268697
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/18/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
81 BEACH ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WESTERLY
Provider Business Mailing Address State Name:
RI
Provider Business Mailing Address Postal Code:
02891-2769
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
401-596-2230
Provider Business Mailing Address Fax Number:
401-596-2401

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
81 BEACH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WESTERLY
Provider Business Practice Location Address State Name:
RI
Provider Business Practice Location Address Postal Code:
02891-2769
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
401-596-2230
Provider Business Practice Location Address Fax Number:
401-596-2401
Provider Enumeration Date:
11/05/2010

Additional Information

Authorized Official

Authorized Official Last Name:
GIANCASPRO
Authorized Official First Name:
JOSEPH
Authorized Official Middle Name:
P.
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
401-596-2230

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: OR0229 . This is a "HEALTH NET" identifier . This identifiers is of the category "OTHER".
  • Identifier: JO84831 , issued by the state of ( RI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 710059201 . This is a "CIGNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0004520533 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 135-1 . This is a "BCBS OF RI" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
  • Identifier: 008025533 , issued by the state of ( CT ) . This identifiers is of the category "MEDICAID".
  • Identifier: 01-0005813RI01 . This is a "ANTHEM BCBS" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 01-00169 . This is a "UNITED HEALTHCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 797828 . This is a "CONNECTICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 9189365 . This is a "PCHS (PRIVATE HEALTHCARE SYSTEMS)" identifier . This identifiers is of the category "OTHER".
  • Identifier: P402612 . This is a "OXFORD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 000877 . This is a "BLUE CHIP (BCBSRI)" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".




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