Individual
DR. ALFRED LIBERO GIANFAGNA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1571 WASHINGTON ST, SUITE 107, WATERTOWN, NY 13601-9319
(315) 782-7330
(315) 782-5773
Mailing address
320 PADDOCK ST, WATERTOWN, NY 13601-9319
(315) 782-7330
(315) 782-5773
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
145633
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00659063
—
NY
Enumeration date
10/02/2006
Last updated
09/07/2012
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