Gianfagna, Joseph C

Gianfagna, Joseph C is an individual health care provider with primary practice located at 1571 Washington St Suite 107, Watertown NY 13601. He recently has 3 registered licenses in different health care specialties including Other Service Providers / Specialist, Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Pediatrics. Allopathic & Osteopathic Physicians / Pediatrics is his primary health care specialty. Gianfagna, Joseph C can be contacted via phone (315) 782-7330.

Contact Information

Primary practice address
1571 Washington St Suite 107 Watertown NY 13601
Phone: (315) 782-7330
Fax: (315) 782-5773
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 268563 New York
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 268563 New York

Profile Details

NPI number 1710207485
LBN Legal business name Gianfagna, Joseph C
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 4th, 2010
Last updated Jan 13th, 2022 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1710207485 NPPES
New York MEDICAID 03635105

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