Provider Demographics
NPI:1982747648
Name:CHARLES V. GIANNASIO, MD, PC
Entity Type:Organization
Organization Name:CHARLES V. GIANNASIO, MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:V
Authorized Official - Last Name:GIANNASIO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:215-643-1135
Mailing Address - Street 1:900 LENMAR DR
Mailing Address - Street 2:SUITE B
Mailing Address - City:BLUE BELL
Mailing Address - State:PA
Mailing Address - Zip Code:19422-2000
Mailing Address - Country:US
Mailing Address - Phone:215-643-1135
Mailing Address - Fax:215-643-0816
Practice Address - Street 1:900 LENMAR DR
Practice Address - Street 2:SUITE B
Practice Address - City:BLUE BELL
Practice Address - State:PA
Practice Address - Zip Code:19422-2000
Practice Address - Country:US
Practice Address - Phone:215-643-1135
Practice Address - Fax:215-643-0816
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
Not Answered2084P0802XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction PsychiatryGroup - Multi-Specialty