Provider Demographics
NPI:1477609931
Name:FAEDDA, GIANNI L (MD)
Entity Type:Individual
Prefix:DR
First Name:GIANNI
Middle Name:L
Last Name:FAEDDA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:245 E 50TH ST
Mailing Address - Street 2:SUITE 2A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-7752
Mailing Address - Country:US
Mailing Address - Phone:212-644-3111
Mailing Address - Fax:212-644-3119
Practice Address - Street 1:245 E 50TH ST
Practice Address - Street 2:SUITE 2A
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-7752
Practice Address - Country:US
Practice Address - Phone:212-644-3111
Practice Address - Fax:212-644-3119
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-26
Last Update Date:2010-05-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY1954122084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYF92149Medicare UPIN