Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0002X | Hospice and Palliative Medicine | 017484 | ME |
NPI | 1184719916 |
---|---|
Provider Name | David F Giansiracusa |
First Address | Portland, ME 04102-3134 |
Second Address | Portland, ME 04102-3134 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/10/2006 |
Last Update Date | 30/07/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D83088 | (02) |