Provider Demographics
NPI:1245752138
Name:IOVINO, GINA MARIE (RN)
Entity Type:Individual
Prefix:
First Name:GINA
Middle Name:MARIE
Last Name:IOVINO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 SANDPIPER LN
Mailing Address - Street 2:
Mailing Address - City:CORAM
Mailing Address - State:NY
Mailing Address - Zip Code:11727-1230
Mailing Address - Country:US
Mailing Address - Phone:631-704-7755
Mailing Address - Fax:
Practice Address - Street 1:2 SANDPIPER LN
Practice Address - Street 2:
Practice Address - City:CORAM
Practice Address - State:NY
Practice Address - Zip Code:11727-1230
Practice Address - Country:US
Practice Address - Phone:631-704-7755
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-12
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY663206163WG0000X, 163WG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0600XNursing Service ProvidersRegistered NurseGerontology
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice