MEDICARE: MR. VINCENT GIAMBANCO III RPH, MS, CGP

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	183500000X	Pharmacist	33313	NY

General Provider Information

NPI Number	:	1235125287
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. VINCENT GIAMBANCO III RPH, MS, CGP

Provider Business Mailing Address
First Line	:	6193 NORTHERN BLVD
Second Line	:
City	:	EAST NORWICH
State	:	NY
Zip	:	11732-1615
Country	:	US
Telephone Number	:	516-922-0166
Fax Number	:

Provider Business Practice Location Address
First Line	:	6193 NORTHERN BLVD
Second Line	:
City	:	EAST NORWICH
State	:	NY
Zip	:	11732-1615
Country	:	US
Telephone Number	:	516-922-0166
Fax Number	:

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

Provider Enumeration Date	:	09/26/2005
Last Update Date	:	07/08/2007

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