Provider Demographics
NPI:1053599555
Name:FRED JOSEPH GIAIMO
Entity type:Organization
Organization Name:FRED JOSEPH GIAIMO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST-OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:FRED
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:GIAIMO
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:603-878-1666
Mailing Address - Street 1:PO BOX 207
Mailing Address - Street 2:670 TURNPIKE ROAD
Mailing Address - City:NEW IPSWICH
Mailing Address - State:NH
Mailing Address - Zip Code:03071-0207
Mailing Address - Country:US
Mailing Address - Phone:603-878-1666
Mailing Address - Fax:
Practice Address - Street 1:670 TURNPIKE ROAD
Practice Address - Street 2:
Practice Address - City:NEW IPSWICH
Practice Address - State:NH
Practice Address - Zip Code:03071-0207
Practice Address - Country:US
Practice Address - Phone:603-878-1666
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-06
Last Update Date:2008-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1397122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH89191868Medicaid
MAXR0101OtherMASS BCBS