Provider Demographics
NPI:1871033142
Name:GIANGREGORIO, TONI
Entity Type:Individual
Prefix:
First Name:TONI
Middle Name:
Last Name:GIANGREGORIO
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 1:2382 CASTLE ROCK CIR
Mailing Address - Street 2:
Mailing Address - City:BULLHEAD CITY
Mailing Address - State:AZ
Mailing Address - Zip Code:86442-4600
Mailing Address - Country:US
Mailing Address - Phone:928-299-9002
Mailing Address - Fax:
Practice Address - Street 1:2382 CASTLE ROCK CIR
Practice Address - Street 2:
Practice Address - City:BULLHEAD CITY
Practice Address - State:AZ
Practice Address - Zip Code:86442-4600
Practice Address - Country:US
Practice Address - Phone:928-299-9002
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-06
Last Update Date:2017-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ374UOOOOOX374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide