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NPI 1992858211

NPI 1992858211 : DAVID GIANETTI M.D. : BRIDGEPORT, CT

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General NPI Number Information
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    NPI Number           |    1992858211
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    Entity Type          |    Individual 
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    Provider Name        |    DAVID GIANETTI M.D.
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    01/19/2007
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    3715 MAIN ST SUITE 410
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    City                 |    BRIDGEPORT
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    State                |    CT
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    Zip                  |    06606-3618
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    Country              |    US
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    Telephone            |    203-374-7882
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    3715 MAIN ST 
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    City                 |    BRIDGEPORT
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    State                |    CT
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    Zip                  |    06606-3618
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    Country              |    US
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    Telephone            |    203-374-7882
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    2084P0800X
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    Taxonomy Name        |    Psychiatry Physician
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    License Number       |    016695
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    License Number State |    CT
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