Provider Demographics
NPI:1558437434
Name:ALECIA M. GIOVINAZZO MD LLC
Entity Type:Organization
Organization Name:ALECIA M. GIOVINAZZO MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:
Authorized Official - Last Name:VENTRONE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-494-2690
Mailing Address - Street 1:450 SLOSSON AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10314-5445
Mailing Address - Country:US
Mailing Address - Phone:718-494-2690
Mailing Address - Fax:718-477-1311
Practice Address - Street 1:450 SLOSSON AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10314-5445
Practice Address - Country:US
Practice Address - Phone:718-494-2690
Practice Address - Fax:718-477-1311
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-24
Last Update Date:2008-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY237013207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYWZXWP1Medicare PIN
NY813E01Medicare PIN