Healthcare Provider Details

I. General information

NPI: 1417193376
Provider Name (Legal Business Name): PROF. GIUSEPPE GIACCONE
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/24/2008
Last Update Date: 01/16/2025
Certification Date: 01/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 CENTER DR
BETHESDA MD
20892-0001
US

IV. Provider business mailing address

7515 MARBURY RD
BETHESDA MD
20817-6222
US

V. Phone/Fax

Practice location:
  • Phone: 301-402-3415
  • Fax:
Mailing address:
  • Phone: 301-320-3482
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code284300000X
TaxonomySpecial Hospital
License NumberD-48393
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License NumberD-48393
License Number StateMD
# 3
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number301563
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: