Provider Demographics
NPI:1790801827
Name:GIANNATTASIO, JOSEPH (DC)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:
Last Name:GIANNATTASIO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:SHAW CHIROPRACTIC GROUP
Mailing Address - Street 2:136 WEST MAIN STREET
Mailing Address - City:NEW BRITAIN
Mailing Address - State:CT
Mailing Address - Zip Code:06052-1315
Mailing Address - Country:US
Mailing Address - Phone:860-225-7429
Mailing Address - Fax:860-826-4765
Practice Address - Street 1:SHAW CHIROPRACTIC
Practice Address - Street 2:136 WEST MAIN STREET - 2ND FLOOR
Practice Address - City:NEW BRITAIN
Practice Address - State:CT
Practice Address - Zip Code:06051
Practice Address - Country:US
Practice Address - Phone:860-225-7429
Practice Address - Fax:860-826-4765
Is Sole Proprietor?:No
Enumeration Date:2007-03-21
Last Update Date:2018-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT1430111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTU88783Medicare UPIN