Provider Demographics
NPI:1578577037
Name:GIANCASPRO, JOSEPH P (MD)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:P
Last Name:GIANCASPRO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:77 FRANKLIN ST
Mailing Address - Street 2:
Mailing Address - City:WESTERLY
Mailing Address - State:RI
Mailing Address - Zip Code:02891-3177
Mailing Address - Country:US
Mailing Address - Phone:401-596-6464
Mailing Address - Fax:401-348-8660
Practice Address - Street 1:77 FRANKLIN ST
Practice Address - Street 2:
Practice Address - City:WESTERLY
Practice Address - State:RI
Practice Address - Zip Code:02891-3177
Practice Address - Country:US
Practice Address - Phone:401-596-6464
Practice Address - Fax:401-348-8660
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2018-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMD05813207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI000877OtherBLUE CHIP
797828OtherCONNECTICARE
RI135IOtherBCBS OF RI
0004520533OtherAETNA
9189365OtherPCHS
0100169OtherUNITED HEALTHCARE
710059201OtherCIGNA
OR0229OtherHEALTH NET
CT010005813RI01OtherANTHEM BC
CT3037884Medicaid
P402612OtherOXFORD
P402612OtherOXFORD
797828OtherCONNECTICARE