=====================================================
General NPI Number Information
=====================================================
NPI Number | 1760722201
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | RALPH GIULIANO
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/20/2013
-----------------------------------------------------
Last Update Date | 02/20/2013
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 120 CLAPBOARD RIDGE RD SUITE 101
-----------------------------------------------------
City | DANBURY
-----------------------------------------------------
State | CT
-----------------------------------------------------
Zip | 06811-3625
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 203-744-5941
-----------------------------------------------------
Fax | 203-797-0865
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 120 CLAPBOARD RIDGE RD SUITE 101
-----------------------------------------------------
City | DANBURY
-----------------------------------------------------
State | CT
-----------------------------------------------------
Zip | 06811-3625
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 203-744-5941
-----------------------------------------------------
Fax | 203-797-0865
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OFFICE ADMIN
-----------------------------------------------------
Name | MISS SARA A WASYLEAN
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 203-744-5941
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1223D0001X
-----------------------------------------------------
Taxonomy Name | Public Health Dentistry
-----------------------------------------------------
License Number | 5240
-----------------------------------------------------
License Number State | CT
-----------------------------------------------------