Peter Giacomazzi, MD
Individual provider Active NPI Internal Medicine Physician · Wolcott, CT
NPI 1710935564 · NPPES record last updated Dec 1, 2021
Key facts
- NPI
- 1710935564
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- 041953 (CT)
- Practice address
- 503 Wolcott Rd
Wolcott, CT 06716-2613 - Phone
- (203) 879-7925
- Fax
- (203) 879-7935
- NPI assigned
- May 4, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 041953 | CT | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| NJ Bariatric Institute LLC | Past |
Accepting new patients | |
| Prospect CT Medical Foundation, Inc. | Internal Medicine | Past | Accepting new patients |
| Ahs Hospital Corp | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 041953 | CT | Yes |
Addresses
Primary practice location
503 Wolcott Rd
Wolcott, CT 06716-2613
Mailing address
503 Wolcott Rd
3Rd Floor
Wolcott, CT 06716
Phone (203) 879-8003
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 001419531 | Medicaid | CT |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | pgiacomazzi42111@direct.stfranciscare.org | Direct | |
| Direct Messaging Address | pgiacomazzi42111@direct.stfranciscare.org | Direct |
Other providers in Wolcott, CT
- Jeremy Gagnon
- Robert Gardner
- Samantha Marie Genovese
- Gericare
- Gericare Psych LLC
- Kayleigh Giannini
- Rachel Kathleen Girouard
- Martin B. Goldstein
- Jeffrey Gonzalez
- Marrhonda Goodwin
All providers in Wolcott, CT · Internal Medicine Physician in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 1, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.