Provider Demographics
NPI:1235125287
Name:GIAMBANCO, VINCENT III (RPH, MS, CGP)
Entity Type:Individual
Prefix:MR
First Name:VINCENT
Middle Name:
Last Name:GIAMBANCO
Suffix:III
Gender:M
Credentials:RPH, MS, CGP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6193 NORTHERN BLVD
Mailing Address - Street 2:
Mailing Address - City:EAST NORWICH
Mailing Address - State:NY
Mailing Address - Zip Code:11732-1615
Mailing Address - Country:US
Mailing Address - Phone:516-922-0166
Mailing Address - Fax:
Practice Address - Street 1:6193 NORTHERN BLVD
Practice Address - Street 2:
Practice Address - City:EAST NORWICH
Practice Address - State:NY
Practice Address - Zip Code:11732-1615
Practice Address - Country:US
Practice Address - Phone:516-922-0166
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY33313183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist