MEDICARE: VINCENZO GIANNELLI MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207N00000X	Dermatology Physician	MD20747	DC

General Provider Information

NPI Number	:	1205881182
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VINCENZO GIANNELLI MD

Provider Business Mailing Address
First Line	:	801 YORK ST
Second Line	:
City	:	MANITOWOC
State	:	WI
Zip	:	54220-4630
Country	:	US
Telephone Number	:	920-663-9035
Fax Number	:	920-684-1439

Provider Business Practice Location Address
First Line	:	2440 M ST NW STE 313
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20037-1449
Country	:	US
Telephone Number	:	202-775-1792
Fax Number	:	202-775-0494

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/23/2006
Last Update Date	:	01/14/2025

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