Healthcare Provider Details

I. General information

NPI: 1720068430
Provider Name (Legal Business Name): JOSEPH GIGANTE DO
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 01/19/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

373 SUNRISE HWY
WEST BABYLON NY
11704-5912
US

IV. Provider business mailing address

373 SUNRISE HWY
WEST BABYLON NY
11704-5912
US

V. Phone/Fax

Practice location:
  • Phone: 631-422-3377
  • Fax: 631-422-3382
Mailing address:
  • Phone: 631-422-3377
  • Fax: 631-422-3382

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number1806091
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: