Provider Demographics
NPI:1942283445
Name:AVOLIO, GIACOMO (MD)
Entity Type:Individual
Prefix:
First Name:GIACOMO
Middle Name:
Last Name:AVOLIO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:JOCK
Other - Middle Name:
Other - Last Name:AVOLIO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 95000-2437
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19195-2437
Mailing Address - Country:US
Mailing Address - Phone:212-844-5525
Mailing Address - Fax:
Practice Address - Street 1:10 UNION SQ E
Practice Address - Street 2:SUITE 5P BETH ISRAEL MED CTR DEPT OF REHAD MEDICINE
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-3314
Practice Address - Country:US
Practice Address - Phone:212-844-5525
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-29
Last Update Date:2021-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY195153208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01774616Medicaid
NY01774616Medicaid
NY92E711Medicare ID - Type Unspecified