# JOHN J GIACCHETTO MD PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1487976676
- **Authorized official:** JOHN J GIACCHETTO MD (PRESIDENT)
- **Authorized official phone:** (860) 889-1116

## Contact information

- **Practice address:** 105 WAWECUS ST, SUITE 2, NORWICH, CT 06360-2146
- **Practice address phone:** (860) 889-1116
- **Practice address fax:** (860) 889-2032
- **Mailing address:** 105 WAWECUS ST, SUITE 2, NORWICH, CT 06360-2146
- **Mailing address phone:** (860) 889-1116
- **Mailing address fax:** (860) 889-2032

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | 026485 | CT | Yes |

## Other

- **Enumeration date:** 02/16/2010
- **Last updated:** 07/28/2014

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 001264853 | — | CT |
| 01 | — | 010026485CT03 | ANTHEM BLUE CROSS AND BLUE SHIELD | CT |
| 01 | — | 030927 | HEALTHNET | — |
| 01 | — | 0461209 | AETNA | — |
| 01 | — | 797371 | CONNECTICARE | — |
| 01 | — | NLS089 | OXFORD | — |