Provider Demographics
NPI:1780689323
Name:GIGLIA, LEWIS G (DPM)
Entity Type:Individual
Prefix:DR
First Name:LEWIS
Middle Name:G
Last Name:GIGLIA
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:430 CROSS KEYS OFFICE PARK
Mailing Address - Street 2:
Mailing Address - City:FAIRPORT
Mailing Address - State:NY
Mailing Address - Zip Code:14450-3506
Mailing Address - Country:US
Mailing Address - Phone:585-223-1633
Mailing Address - Fax:585-421-8093
Practice Address - Street 1:430 CROSS KEYS OFFICE PARK
Practice Address - Street 2:
Practice Address - City:FAIRPORT
Practice Address - State:NY
Practice Address - Zip Code:14450-3506
Practice Address - Country:US
Practice Address - Phone:585-223-1633
Practice Address - Fax:585-421-8093
Is Sole Proprietor?:No
Enumeration Date:2005-06-20
Last Update Date:2007-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN003357213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYT26170Medicare UPIN
NYCC8484Medicare ID - Type Unspecified