Individual
GIANNI B MIGLIACCIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
800 TYDINGS LN, HAVRE DE GRACE, MD 21078-2102
(410) 273-6600
(410) 734-2305
Mailing address
800 TYDINGS LN, HAVRE DE GRACE, MD 21078-2102
(410) 273-6600
(410) 734-2305
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0110003850
VA
363A00000X
Physician Assistant
Primary
C05654
MD
363AM0700X
Medical Physician Assistant
012255
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02951164
—
NY
Enumeration date
08/31/2007
Last updated
10/16/2023
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