Provider Demographics
NPI:1003665837
Name:GIANNELLI, WILLIAM THOMAS FLYNN
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:THOMAS FLYNN
Last Name:GIANNELLI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1002 MILCHLING DR
Mailing Address - Street 2:
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21015-1574
Mailing Address - Country:US
Mailing Address - Phone:443-752-2554
Mailing Address - Fax:
Practice Address - Street 1:1002 MILCHLING DR
Practice Address - Street 2:
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21015-1574
Practice Address - Country:US
Practice Address - Phone:443-752-2554
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-14
Last Update Date:2024-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program