Provider Demographics
NPI:1750325684
Name:GIANNAKAROS, JAMES (DPM)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:
Last Name:GIANNAKAROS
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 1:1 LEIFRIED LN
Mailing Address - Street 2:SUITE B
Mailing Address - City:LITTLE EGG HARBOR TWP
Mailing Address - State:NJ
Mailing Address - Zip Code:08087-2000
Mailing Address - Country:US
Mailing Address - Phone:609-294-2666
Mailing Address - Fax:609-294-0606
Practice Address - Street 1:1 LEIFRIED LN
Practice Address - Street 2:SUITE B
Practice Address - City:LITTLE EGG HARBOR TWP
Practice Address - State:NJ
Practice Address - Zip Code:08087-2000
Practice Address - Country:US
Practice Address - Phone:609-294-2666
Practice Address - Fax:609-294-0606
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2007-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMD 002520213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ4966800001OtherMEDICARE NSC
NJ8138702Medicaid
NJMD 002520OtherNJ LICENSE
NJU75333Medicare UPIN
NJ073949Medicare ID - Type UnspecifiedMEDICARE #