Provider Demographics
NPI:1235141953
Name:DIGIOVANNA, GERI EILEEN (DO)
Entity Type:Individual
Prefix:
First Name:GERI
Middle Name:EILEEN
Last Name:DIGIOVANNA
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:850 HICKSVILLE RD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:SEAFORD
Mailing Address - State:NY
Mailing Address - Zip Code:11783-1300
Mailing Address - Country:US
Mailing Address - Phone:516-809-4200
Mailing Address - Fax:516-809-4425
Practice Address - Street 1:850 HICKSVILLE RD
Practice Address - Street 2:SUITE 110
Practice Address - City:SEAFORD
Practice Address - State:NY
Practice Address - Zip Code:11783-1300
Practice Address - Country:US
Practice Address - Phone:516-809-4200
Practice Address - Fax:516-809-4425
Is Sole Proprietor?:No
Enumeration Date:2006-08-12
Last Update Date:2015-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY188047207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01504810Medicaid
NY01504810Medicaid
NY69H701Medicare ID - Type Unspecified