Provider Demographics
NPI:1851832083
Name:DIGRIGOLI, TINA
Entity Type:Individual
Prefix:
First Name:TINA
Middle Name:
Last Name:DIGRIGOLI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:46 PERONA LN
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10308-3323
Mailing Address - Country:US
Mailing Address - Phone:917-517-2976
Mailing Address - Fax:
Practice Address - Street 1:46 PERONA LN
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10308-3323
Practice Address - Country:US
Practice Address - Phone:917-517-2976
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-20
Last Update Date:2017-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator