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Individual

DR. RAYMOND JOHN GIANFRIDDO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
3236 BROADWAY ST, QUINCY, IL 62301-3712
(217) 228-2060
(217) 228-2066
Mailing address
3833 LANCASTER LN, QUINCY, IL 62305-8613
(217) 224-1204
(217) 224-2041

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046007043
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
294874
HEALTHLINK TRISTATE COALI
IL
01
410021483
RAILROAD MEDICARE
IL
01
IL7043
EYEMED
IL
Enumeration date
06/14/2006
Last updated
06/18/2015
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