MEDICARE: JOHN J GIACCHETTO MD PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207X00000X	Orthopaedic Surgery Physician	026485	CT

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	200006652	OTHER	CT	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	030927	OTHER	CT	HEALTHNET
4	0904228	OTHER	CT	UNITED HEALTHCARE
5	797371	OTHER	CT	CONNECTICARE
6	010026485CT03	OTHER	CT	ANTHEM BC & BS
7	461209	OTHER	CT	AETNA
8	NLS089	OTHER	CT	OXFORD

General Provider Information

NPI Number	:	1427052380
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN J GIACCHETTO MD PC

Provider Business Mailing Address
First Line	:	105 WAWECUS ST
Second Line	:	SUITE 2
City	:	NORWICH
State	:	CT
Zip	:	06360-2146
Country	:	US
Telephone Number	:	860-889-1116
Fax Number	:	860-889-2032

Provider Business Practice Location Address
First Line	:	105 WAWECUS ST
Second Line	:	SUITE 2
City	:	NORWICH
State	:	CT
Zip	:	06360-2146
Country	:	US
Telephone Number	:	860-889-1116
Fax Number	:	860-889-2032

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/09/2005
Last Update Date	:	07/28/2014

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Directions to “ JOHN J GIACCHETTO MD PC” Practice Location

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