Provider Demographics
NPI:1346354156
Name:GIOVANNI, JEANNINE (MD)
Entity Type:Individual
Prefix:
First Name:JEANNINE
Middle Name:
Last Name:GIOVANNI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 PROVIDENCE PL
Mailing Address - Street 2:#255
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02903-1761
Mailing Address - Country:US
Mailing Address - Phone:860-965-1994
Mailing Address - Fax:
Practice Address - Street 1:RHODE ISLAND SURGEONS, INC
Practice Address - Street 2:1539 ATWOOD AVENUE SUITE 201
Practice Address - City:JOHNSTON
Practice Address - State:RI
Practice Address - Zip Code:02919-3262
Practice Address - Country:US
Practice Address - Phone:401-521-6310
Practice Address - Fax:401-861-9596
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-18
Last Update Date:2008-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMD12222208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI413730OtherBCBS BLUE CHIP
RI542117194OtherUNITED HEALTH
RI31821OtherBC BS
RIRI12222OtherRH LICENSE
RI542117194OtherUNITED HEALTH
RII11296Medicare UPIN