Provider Demographics
NPI:1497222590
Name:DIGIACOMO, GIANNI MICHAEL
Entity Type:Individual
Prefix:
First Name:GIANNI
Middle Name:MICHAEL
Last Name:DIGIACOMO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1030 JOHNSON RD STE 180
Mailing Address - Street 2:
Mailing Address - City:GOLDEN
Mailing Address - State:CO
Mailing Address - Zip Code:80401-6046
Mailing Address - Country:US
Mailing Address - Phone:720-744-0114
Mailing Address - Fax:
Practice Address - Street 1:1030 JOHNSON RD STE 180
Practice Address - Street 2:
Practice Address - City:GOLDEN
Practice Address - State:CO
Practice Address - Zip Code:80401-6046
Practice Address - Country:US
Practice Address - Phone:720-744-0114
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-26
Last Update Date:2018-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0000361237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist