Basic Information
| Provider Information | |||||||||
| NPI: | 1639165939 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GIACOBBE | ||||||||
| FirstName: | DEAN | ||||||||
| MiddleName: | THOMAS | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | H3 SHIRLEY LN | ||||||||
| Address2: | |||||||||
| City: | LAWRENCE | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 086481425 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9736761000 | ||||||||
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| Practice Location | |||||||||
| Address1: | H3 SHIRLEY LN | ||||||||
| Address2: | |||||||||
| City: | LAWRENCE | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 086481425 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9736761000 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/22/2005 | ||||||||
| LastUpdateDate: | 09/30/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | 25MA08759200 | NJ | Y | Allopathic & Osteopathic Physicians | Anesthesiology | 207LP2900X | 25MA08759200 | NJ | N | Allopathic & Osteopathic Physicians | Anesthesiology | Pain Medicine |
No ID Information.