Basic Information
Provider Information
NPI: 1407810831
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: GIULIANO
FirstName: JOHN
MiddleName: SEBASTIAN
NamePrefix:  
NameSuffix: JR.
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 20 YORK ST
Address2: PEDIATRIC CRITICAL CARE
City: NEW HAVEN
State: CT
PostalCode: 06520
CountryCode: US
TelephoneNumber: 2037854651
FaxNumber: 2037855833
Practice Location
Address1: 20 YORK ST
Address2: PEDIATRIC CRITICAL CARE
City: NEW HAVEN
State: CT
PostalCode: 06520
CountryCode: US
TelephoneNumber: 2037854651
FaxNumber: 2037855833
Other Information
ProviderEnumerationDate: 04/13/2006
LastUpdateDate: 09/24/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 09/24/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2080P0203X046521CTY Allopathic & Osteopathic PhysiciansPediatricsPediatric Critical Care Medicine

No ID Information.


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