# GIANNI PERSICH DPM

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

## Provider details

- **NPI number:** 1770747891
- **Authorized official:** DR. GIANNI PERSICH DPM (SOLE PROPRIETOR)
- **Authorized official phone:** (718) 777-0360

## Contact information

- **Practice address:** 4207 30TH AVE, ASTORIA, NY 11103-2910
- **Practice address phone:** (718) 777-0360
- **Practice address fax:** (718) 777-3180
- **Mailing address:** 4207 30TH AVE, ASTORIA, NY 11103-2910
- **Mailing address phone:** (718) 777-0360
- **Mailing address fax:** (718) 777-3180

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | N004789 | NY | Yes |

## Other

- **Enumeration date:** 07/17/2008
- **Last updated:** 08/04/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | P376490 | OXFORD | NY |
| 01 | — | P52221 | EMPIRE BLUE CROSS | NY |