1891776332 NPI number — PHILIP A GIAMMARINO D.P.M.

Table of content: PHILIP A GIAMMARINO D.P.M. (NPI 1891776332)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1891776332 NPI number — PHILIP A GIAMMARINO D.P.M.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GIAMMARINO
Provider First Name:
PHILIP
Provider Middle Name:
A
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
D.P.M.
Provider Gender Code:
M

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:
1891776332
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8607 21ST AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BROOKLYN
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11214-4003
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
718-266-1986
Provider Business Mailing Address Fax Number:
718-266-2203

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8607 21ST AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BROOKLYN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11214-4003
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-266-1986
Provider Business Practice Location Address Fax Number:
718-266-2203
Provider Enumeration Date:
11/10/2005

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 213ES0103X , with the licence number:  N002850-1 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 0003330 . This is a "GHI" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 36584P . This is a "HIP" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 4C1957 . This is a "HEALTHNET" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 61986 . This is a "ELDERPLAN" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: MCA035201 . This is a "AMERICHOICE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 00418644 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 4229176 . This is a "AETNA US HEALTHCARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: KS894 . This is a "OXFORD" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 62210946 . This is a "ATLANTIS" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 2511826 . This is a "TOUCHSTONE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: P32051 . This is a "BLUECROSS BLUESHIELD" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".