Individual
ANNETTE LYNN GIANGIACOMO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1087 W MASON ST, GREEN BAY, WI 54303-1859
(920) 499-3102
(920) 499-9636
Mailing address
1087 W MASON ST, GREEN BAY, WI 54303-1859
(920) 499-3102
(920) 499-9636
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
2006-01410
NC
207W00000X
Ophthalmology Physician
Primary
44891
WI
207W00000X
Ophthalmology Physician
A91112
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A911120
MEDICAL PPIN #
CA
Enumeration date
07/25/2006
Last updated
06/04/2024
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