Healthcare Provider Details

I. General information

NPI: 1134703390
Provider Name (Legal Business Name): JOSEPH GIANNETTA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/12/2021
Last Update Date: 07/11/2025
Certification Date: 07/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

918 ULSTER AVE
KINGSTON NY
12401-1372
US

IV. Provider business mailing address

1910 SOUTH RD
POUGHKEEPSIE NY
12601-6053
US

V. Phone/Fax

Practice location:
  • Phone: 845-339-8900
  • Fax:
Mailing address:
  • Phone: 845-454-0120
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License Number332193
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: