Provider Demographics
NPI:1033560156
Name:GIANAKOS, DIANNE L (RPH)
Entity Type:Individual
Prefix:
First Name:DIANNE
Middle Name:L
Last Name:GIANAKOS
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 CHRYSTAL DR
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:NJ
Mailing Address - Zip Code:08833-3245
Mailing Address - Country:US
Mailing Address - Phone:908-727-0025
Mailing Address - Fax:
Practice Address - Street 1:16 CHRYSTAL DR
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:NJ
Practice Address - Zip Code:08833-3245
Practice Address - Country:US
Practice Address - Phone:908-727-0025
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-30
Last Update Date:2016-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI01648600183500000X
PARP450016183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist