Provider Demographics
NPI:1285637025
Name:GIACALONE, VINCENT FRANCIS (DPM)
Entity Type:Individual
Prefix:DR
First Name:VINCENT
Middle Name:FRANCIS
Last Name:GIACALONE
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:466 OLD HOOK RD
Mailing Address - Street 2:STE 24D
Mailing Address - City:EMERSON
Mailing Address - State:NJ
Mailing Address - Zip Code:07630-1368
Mailing Address - Country:US
Mailing Address - Phone:201-261-0500
Mailing Address - Fax:201-261-7905
Practice Address - Street 1:466 OLD HOOK RD
Practice Address - Street 2:STE 24D
Practice Address - City:EMERSON
Practice Address - State:NJ
Practice Address - Zip Code:07630-1368
Practice Address - Country:US
Practice Address - Phone:201-261-0500
Practice Address - Fax:201-261-7905
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-24
Last Update Date:2009-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MD00192300213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ4566106Medicaid
T96156Medicare UPIN
4679980001Medicare NSC
GI630746Medicare PIN