Provider Demographics
NPI:1780667477
Name:GIOVINAZZO, LARRY (AUD)
Entity Type:Individual
Prefix:DR
First Name:LARRY
Middle Name:
Last Name:GIOVINAZZO
Suffix:
Gender:M
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8700 E MARKET ST
Mailing Address - Street 2:SUITE 2
Mailing Address - City:HOWLAND
Mailing Address - State:OH
Mailing Address - Zip Code:44484-2340
Mailing Address - Country:US
Mailing Address - Phone:330-372-4500
Mailing Address - Fax:330-372-4540
Practice Address - Street 1:8700 E MARKET ST
Practice Address - Street 2:SUITE 2
Practice Address - City:HOWLAND
Practice Address - State:OH
Practice Address - Zip Code:44484-2340
Practice Address - Country:US
Practice Address - Phone:330-372-4500
Practice Address - Fax:330-372-4540
Is Sole Proprietor?:No
Enumeration Date:2005-11-28
Last Update Date:2008-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHA1063237600000X, 231H00000X, 231HA2400X, 231HA2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
No231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No231HA2400XSpeech, Language and Hearing Service ProvidersAudiologistAssistive Technology Practitioner
No231HA2500XSpeech, Language and Hearing Service ProvidersAudiologistAssistive Technology Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2188798Medicaid
OH2188798Medicaid
OHGI4151331Medicare ID - Type UnspecifiedINDIVIDUAL
OHAU9350321Medicare ID - Type UnspecifiedGROUP NUMBER