Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0131X | Foot Surgery | 25MD00273D | NJ |
N | 213ES0131X | Foot Surgery | SC004702L | PA |
NPI | 1235149733 |
---|---|
Provider Name | Dr. Bernadette Giangreco |
First Address | Hainesport, NJ 08036-2767 |
Second Address | Hainesport, NJ 08036-2767 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/08/2006 |
Last Update Date | 30/12/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
V00083 | (02) |