1538168117 NPI number — DANIEL R GACCIONE MD

Table of content: DANIEL R GACCIONE MD (NPI 1538168117)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1538168117 NPI number — DANIEL R GACCIONE MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GACCIONE
Provider First Name:
DANIEL
Provider Middle Name:
R
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
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:
1538168117
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/12/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
101 AIRPORT RD.
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
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
401-596-0259
Provider Business Mailing Address Fax Number:
401-348-5934

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
101 AIRPORT RD
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
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
401-596-0259
Provider Business Practice Location Address Fax Number:
401-348-5934
Provider Enumeration Date:
07/18/2005

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: 207X00000X , with the licence number:  MD07085 , registered in the state of RI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207X00000X , with the licence number: 034988 , registered in the state of CT ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 010007085RI02 . This is a "ANTHEM BC/BS" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
  • Identifier: 0901058 . This is a "UNITED HEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 22654-7 . This is a "BCBS" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
  • Identifier: 2V1386 . This is a "HEALTHNET" identifier . This identifiers is of the category "OTHER".
  • Identifier: 010034988CT02 . This is a "ANTHEM BC/BS" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com