Provider Demographics
NPI:1730508375
Name:GIACCA, GIANFRANCO
Entity type:Individual
Prefix:
First Name:GIANFRANCO
Middle Name:
Last Name:GIACCA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 S YORK RD
Mailing Address - Street 2:
Mailing Address - City:HATBORO
Mailing Address - State:PA
Mailing Address - Zip Code:19040-3231
Mailing Address - Country:US
Mailing Address - Phone:215-443-7700
Mailing Address - Fax:215-443-8255
Practice Address - Street 1:25 S YORK RD
Practice Address - Street 2:
Practice Address - City:HATBORO
Practice Address - State:PA
Practice Address - Zip Code:19040-3231
Practice Address - Country:US
Practice Address - Phone:215-443-7700
Practice Address - Fax:215-443-8255
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-10
Last Update Date:2014-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP044162L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist